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fq%l\ and RELIGION 



Digitized by the Internet Archive 

in 2010 with funding from 

Lyrasis IVIembers and Sloan Foundation 




University of Illinois 







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D. Van Nostrand Company, Ltd. 
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D. Van Nostrand Company (Canada), Ltd. 
25 Hollinger Road, Toronto 16, Canada 

^Copyright @ 1961, by 

Published simultaneously in Canada by 
D. Van Nostrand Company (Canada), Ltd. 

No reproduction in any form of this hook, in 
whole or in part [except for brief qilutation in 
critical articles or reviews) may be made with- 
out written authorization from the publishers 

printed in the united states of AMERICA 


One day, while this book was still in preparation, I 
was chatting with a student who, amiably but not very 
discerningly, asked if it would be the first to appear 
in the psychiatry-religion area. In reply I pointed to 
two piles of books, each nearly two feet high, on a 
nearby table and suggested that he run his eye down over 
the titles. Here, I told him, was only a part of my per- 
sonal collection of such books and added that there are 
many more which I do not possess. 

The more pertinent question, therefore, is why should 
I, why should anyone, write yet another book in tLw 
area? The answer, to which the prosp?^' reader is 
immediately entitled, is that tl^'3 book '- duferent — in a 
way which, at least crudely, can be quickly stated. The 
typical psychiatry-religion book, subtly or boldly, promises 
"peace of mind" to the reader on the premise that psy- 
chiatry is wonderful, religion is wonderful, put them 
together and you get something better still! More accu- 
rately, the situation might be likened to that of two 
aging lovers who have married, each with the illusion 
taat the other has "lesources" which have been implied 
but, thus far, not concretely exhibited. The thesis of 
this collection of articles and lectures is that the honey- 
moon '3 now coming to an end and that crisis, not 
connubial bliss, is the term we need to describe the 
resulting situation. 

This book contains, therefore, no "prescription for 
anxiety," according to the familiar formula. Here we 
shall proceed on the assumption that our problems in 
this area are not purely ''personal" but have instead 
broadly social, historical, scientific, and professional di- 
mensions. And the invitation to the reader is thus to 
join in a quest and a commitment which, while not 
immediately "anxiety reducing," may, in the long run, 
be more so than the soothing, personalized approaches 




which are today being offered in such profusion. In othei" 
words, to borrow a useful distinction from the sociologisl^ 
C. Wright Mills, it seems that instead of merely having 
troubles — of a highly particularized sort, to which there ^ 
are known, readily available, standard solutions — we here^ 
face broad and complex issues, which must be recognized^ 
openly and honestly, and dealt with accordingly. ' 

Until roughly a century ago, psychology, philosophy^ 
and religion, in both the popular and academic mind.' 
were essentially one discipline. But then, in an attempl' 
to separate the empirical from the speculative, the scien-^ 
tific from the metaphysical, psychology and its medical 
counterpart, psychiatry, made a determined effort tc 
establish themselves as independent enterprises. In certain 
limited respects, this separation or fissioning has been' 
successful; but in other, perhaps more important ways, 
it has brought serious difficulties in its wake. Human 
beings, whether in sickness or in health, are manifestly 
not divided into clear-cut psychological, philosophical, 
and religious entities. And our efforts, in the separate' 
professions, to understand and minister to human need 
have been far less effective than we would like. In light 
of this situation, it is understandable that, for some years 
now, there has been a tendency, particularly on the part 
of psychiatry and religion, to "get together" again. 
Certainly there is much to commend and support such 
a movement; but there are also some major complications 
— which constitute the crisis with which this book is 
centrally concerned. 

Traditionally, it has been recognized that man is pre- 
eminently a social being — or, in theological phrase, a 
"child of God." However, clinical psychology and psy- 
chiatry, in an effort to consolidate their separation from 
religion, have been powerfully attracted by the alterna- 
tive emphasis of Freudian psychoanalysis upon the bio- 
logical, rather than social and moral, nature of man's 
deepest aspirations. Currently, in this area, we are hear- 
ing a good deal about a new interest in values. More 
precisely, we should refer to this as merely a change in 
our conception of the good, the valuable. Psychoanalysis 
has always had (at least tacitly) a "value system," one 
in which "adult genital sexuality" (capacity for lusty 
heterosexual orgasm) and unencumbered "assertiveness" 


vhich often eventuates as frank hostility and aggressive- 
^ss) occupy positions of supreme importance. 
In psychiatry and cHnical psychology there is now, 
elatedly, a growing realization that such a disingenuous 
Qorality is more likely to cause than cure personality 
Jviation and disorder. But, paradoxically, this re-awaken- 
g on the part of the secular professions concerned with 
waling is currently a barrier, rather than an asset, in 
eir efforts to interact with religion; for the latter has 
so been deeply saturated with this same disingenuous 
)Ctrine and is having a hard time shaking free of it. 
major objective of the present collection of recently 
iblished papers and lectures is to facilitate the process 
disenchantment and thus help liberate religion for 
e more substantial accomplishments, both in conjunc- 
)n with psychology and psychiatry and in its own right, 
lich seem to be clearly within its reach — and also, 
)pefully, to help psychology and psychiatry, in what- 
er collaboration with religion may be logically indi- 
ted, to develop in more promising and effective di- 

This book is therefore addressed primarily to psycholo- 
its and psychiatrists, on the one hand, and to semi- 
jrians and clergymen, on the other, but also to the 
mbers of such ''intermediate" professions as educa- 
»n, social work, and law. Manifestly it is not a text- 
ok, in the conventional sense of the term; yet, on two 
Jerent occasions, a mimeographed version thereof has 
Ted very satisfactorily in this role. During the Spring 
nester of this year, Dr. Perry London and I gave an ad- 
nced graduate seminar on "The Nature and Manage- 
nt of Guilt," with these materials as the focus of our 
ention; and during the summer I also used these ma- 
ials as a "text" in a course on "Mental Hygiene for 
;achers." But this book will very likely find its greatest 
idemic usefulness as supplementary reading and as the 
sis for special discussions in a variety of subject-matter 

This is not to say, of course, that more systematic and 
borate treatises will not ultimately be written from 
I standpoint of the general position which is here 
ighly delineated. We are, I believe, definitely in proc- 
j of abandoning psychoanalysis, both as personality 



theory and as would-be therapy — and also, very possiblj 
those forms of theology which have allowed themselvej 
to become most seriously adulterated by it. To the d 
tent, then, that this book expedites such development' 
it is admittedly "negative," ''destructive." But it alsj 
points, hopefully and unequivocally, to the social bas' 
of both the genesis and correction of psychopatholog* 
and thus provides the basis for a broad and potential] 
very powerful and constructive attack upon our problen 
in this area. 

Some readers will, I imagine, sense a similarity h 
tween this approach and that somewhat amorphous bi 
presently vigorous movement known as Existentialisn 
To the extent that the latter is in revolt agairisMth 
denial and debasement of human responsibility whic 
have been foisted upon us alike by Calvinist theology 
Freudian psychoanalysis, and academic Behaviorism, th 
present approach is indeed similar. But here the readd 
will, I trust, find none of the cultishness and mysticisij 
which so often characterize Existentialism, in its varioii 
forms. Here the aim is to keep well within the bound 
of common sense and scientific thought, but at the sarn 
time to take a sufficiently broad view of the human entd 
prise to include also a considerable segment of what ' 
ordinarily termed "morality" and "religion." ' 

Much of the incentive for bringing this collectio 
of documents together in book form comes from tli 
friendly, yet thoughtful and concerned way in whic 
they have been received, as articles and lectures, by th 
various professional and lay groups to which they ha\ 
been addressed. These reactions have been both a 
encouragement and a challenge, for which I am extreme] 
grateful. The title of each chapter is followed by 
footnote which indicates the chapter's origin: if a 
article, the place of prior publication; if a lecture, tli 
circumstances of its delivery. And at the outset of eac 
chapter there is also a brief introductory statemen 
designed to highlight the argument of the book as 
whole and to link successive chapters together. Howeve 
it is here that I wish to express my very warm appreci. 
tion to the Pacific School of Religion for the invitatio 
to deliver the E. T. Earl Lectures for 1960 and to Nort 
Park College and Seminary for a similar opportunity 1 


jive the David Nyvall Lectures for 1960. These lectures 
ire reproduced in full, as Chapters 8, 9, and 10, and 
[l and 12, respectively. And in September, the latter 
jvere presented, as the first of the Geehns Lectures for 
ihis academic year, at the Southern Baptist Theological 
Seminary, in Louisville, Kentucky. I shall long remember, 
^^ith much pleasure, the many personal courtesies ex- 
fended to me on these occasions and the helpfulness of 
he comments and criticisms which I thus received. 
! Also, I take pleasure in acknowledging the gener- 
osity of those authors and publishers who have granted 
permission to quote from other works, and in expressing 
py gratitude to Miss Leona D. Pedigo and Mrs. Donald 
fV. Keefer for highly competent secretarial assistance in 
^e preparation, proofing, and indexing of this book. 
I Although the materials here assembled were originally 
lirected, in most instances, to professional audiences — 
)sychiatrists, psychologists, educators, and theologians, 
he language is essentially nontechnical and can be un- 
lerstood by any interested layman. And because the issues 
mder discussion are so vital to our very existence, both 
s individuals and as a people, I believe that many lay- 
nen, as well as specialists, will be interested. To this 
nd, the book has been deliberately kept small and the 
ormat inexpensive. 

O. H. M. 

Urhana, Illinois 

December y I960 


1. Some Philosophical Problems in Psycho- 

logical Counseling 

2. Changing Conceptions of the Uncon- 


3. Some Constructive Features of the Con- 

cept OF Sin 

4. "Sin," The Lesser of Two Evils 

5. Judgment and Suffering: Contrasting 


6. The New Challenge to Our Churches 

AND Seminaries: I. A Question of Theory 

7. The New Challenge to Our Churches 

AND Seminaries: II. The Problem of Ac- 

8. Psychopathology and the Problem of 

Guilt, Confession, and Expiation 

9. Psychotherapy and the Problem of Val- 

ues IN Historical Perspective or The 
Devil and Psychopathology 

10. Psychology, Theology, and the Social 


11. Protestant Christianity: I. Ambiguity and 


12. Protestant Christianity: II. Challenge and 


13. Footnotes to a Theory of Psychopathol- 

Bibliography and Author Index 
Subject Index 





with gratitude for their faith in 
the ultimate unity of psychology and religion 


Some Philosophical Problems 
in Psychological Counseling* 

This paper is centrally concerned with certain historical 
md cultural dimensions of the crisis in psychiatry and 
eligion. Academic psychology [particularly here in Amer- 
ca) and Freudian psychoanalysis (an indigenous Euro- 
pean movement) were both powerfully influenced by 
he Darwinian conception of organic evolution, which 
egarded mind as essentially an ''organ of adaptation.'* 
This type of approach has, in some ways, been extremely 
iseful. However, there are today signs of acute unrest in 
ioth psychiatry and psychology. Personal disorganization 
md psychopathology persist as great unsolved problems 
n our time; and there is growing conviction that the 
ninciples and conditions of biological adaptation and 
urvival do not necessarily provide the understanding 
ieeded for psychological survival. Human beings are 
nore than mere bodies, organisms, physiological entities; 
^hey are also persons. And personality, it seems, can be 

\ * Previously published in the Journal of Counseling Psychol- 
ogy, 1957, 4, 103-111; also read, under a different title ("A 
i*ractical. Contemporary Aspect of the Mind-Body Problem"), 
t the Eighth Annual Institute in Psychiatry and Neurology held, 
jinder the auspices of the Veterans Administration, in North Lit- 
le Rock, Arkansas (March, 1956). Between then and the 
Ime of original publication, a number of other pertinent refer- 
Tices came to the writer's attention and were listed, for the 
eader's convenience, as follows: Blake (1955), Fingarette 
'1955), Gallagher (1956), Hobbs (1956), Liften (1953), 
ylaslow (1956), Roberts (1956), Schneiderman (1954), Sho- 
,.en (1955, 1956), Waiters (1955), White (1952), and Wil- 
[amson (1956). And to this list a comment was added, "Al- 
hough these papers do not by any means all take the same 
losition as does the present author, they are unanimous in 
ailing for a re-appraisal of the philosophical premises on which 
ontemporary psychotherapy, counseling, and even diagnosis are 

2 The Crisis in Psychiatry and Religion 

' properly understood and appreciated only in terms of 
sociality, i.e., interpersonal and moral values systems. 

Religion is, of course, deeply concerned with man as 
person and personality; and in their shifting percep- 
tion of man-as-hody to man-as-person, psychology and 
psychiatry find themselves looking again, with renewed 
interest and respect, at religious precept and practice. 
Whatever may he the incompatibility of religion and 
these secular disciplines in the metaphysical realm, here, 
in the study of personality in its social and ethical dimen- 
sions, is a natural and favorable meeting place. Although 
it is at present impossible to foresee how far the rap- 
prochement of religion and psychiatry, broadly con- 
ceived, will eventually go, here, manifestly, is the place 
to start. 

Is mind designed to serve the body or is body designed 
to serve the mind? During the last half century, assent 
has been so nearly universally given by psychologists to 
the first of these possibilities that the alternative view 
has hardly been considered at all. 

But there are signs that all is not well with psychology, 
either as science or as profession, and that we may need 
to re-examine some of our most basic assumptions. Ask 
a representative sample of bright, young clinical psychol- 
ogists who got their doctorate degrees at our best uni- 
versities four or five years ago and who have since been 
on the clinical firing line, ask them what they now think 
of their training in light of their attempts to make appli- 
cation thereof. Without bitterness, self-pity, or even 
undue pessimism, they commonly express doubts of the 
most profound and far-reaching nature. They question 
both the instruments and the categories of diagnosis; 
they feel that the rationale and results of psychotherapy 
and counseling are uncertain; and they divergently evalu- 
ate the significance of recent contributions to psychology 
as a science. 

Or, listen to what some of our elder statesmen have 
to say in this connection. In 1955 the American Psychi- 
atric Association sponsored an all-day symposium, by 
psychiatrists and psychologists, on psychotherapy— later 
published in book form under the title. Progress in Psy- 

Philosophical Problems in Counseling 3 

chotherapy (Fromm-Reichmann and Moreno, 1956). 
Here are some of the comments made on this occasion: 

Psychiatry has a great need for a clear and rational 
understanding of the process of recovery. . . . Hypotheses 
we have, . . . but none has gained that degree of validation 
which should serve to command general acceptance in the 
medical profession as a well-established theory (Whitehorn, 
p. 62). 

Psychotherapy has many more variants than psychoanalysis 
and what constitutes psychotherapy, and what does not, is 
even less clear than what is, or is not, psychoanalysis. . . . 
The time has come to investigate not the differences but the 
similarities, and to formulate common denominators among 
the bewildering array of different methods and procedures 
(Hoch, pp. 72-73). 

It is discontent which drives me in my approach to this 
problem. Only a few years ago (although it seems a long 
time in my life as a psychoanalyst) I harbored the comfort- 
ing expectation that increasing analytic sophistication and 
experience would yield a higher percentage of therapeutic 
successes. . . . My reluctant impression is that this hope 
has not been realized (p. 87). I am impatient with any 
propagandish approach to the problem from any point of 
view. We have no right to be for or against anything in 
this field. We have a right only to the most complete 
humility — humility that says we still know practically nothing 
about many important elements either in the neurotic process 
or in the psychotherapeutic process) (Kubie, p. 101). 

Psychotherapy is today in a state of disarray, almost ex- 
actly as it was two hundred years ago (p. 108). At this stage 
we seem to be fighting each other to attain some sort of 
theoretic throne, and we often forget that that throne is as 
unsteady as a three-legged chair (Zilboorg, p. 110). 

Or, take still a different sort of evidence that we have 
failed to meet manifest social need in this connection. 
One of the most remarkable and unanticipated develop- 
ments on the whole contemporary human scene is the 
extent to which religious leaders are thinking about and 
actively working at the problem of personality disorder. 
Books on religion and pastoral counseling are being pub- 
lished at an unprecedented rate, and if one takes the 
trouble to examine them, one finds that they are some- 
times quite thoughtful, informed, and creative. "Men- 
tal Health" is a common pulpit topic; and to the twin 

4 The Crisis in Psychiatry and Religion 

concepts of "Sin and Salvation" has been added, "and 
Sanity." Moreover, and even more remarkable, it seems 
that the profession of psychiatry is now beginning to 
think in a new way about the role of religion in mental 
health and illness: witness the just-published books by 
Viktor Frankl of Vienna (1953) and by the English 
psychiatrist, Ernest White (1955). For similar trends 
in this country, see The Church and Mental Health 
(Maves, 1953) and Ministry and Medicine in Human 
Relations (Galdston, 1955). And the same trend is also 
conspicuous in Progress in Psychotherapy (Fromm-Reich- 
mann and Moreno, 1956). 

Granted, then, the reality of psychology's ailment, 
what precisely is the diagnosis, what the remedy? 


The writer has just read Boring's paper (1950) on 
"The Influence of Evolutionary Theory upon American 
Psychological Thought." It is most suggestive. Boring 
begins by noting a paradox, that in the latter part of the 
nineteenth century, American psychologists were busy 
ostensibly imitating and importing one kind of psy- 
chology from Germany while, almost unwittingly, creat- 
ing something very different. This was Functionalism 
and, a little later. Behaviorism. Here Darwinian thought 
was the touchstone. Says Boring: 

To his thinking about psychology Dewey brought the con- 
cept of functional use for the events of the mind, and thus, 
closely related to functional use, the notion of functional 
/activity. The way to express this matter is to say that both 
I consciousness and activity function for the organism — the 
luse of consciousness is to produce activity which "saves" the 
organism. That is the essential tenet of the Chicago school of 
functional psychology which Dewey started, and which An- 
gell carried on. In the doctrine of this school behavior and 
physiology and conscious states are mixed in with each other 
because they are unified, not by their essential natures, but 
by their common aim for the survival and use of the 
organism (p. 277). 

Boring then goes on to say that, in his judgment 
(Watson to the contrary). Behaviorism was a direct 
outgrowth "of Dewey's functionalism and of Cattell's 

Philosophical Problems in Counseling 5 

capacity psychology. . . . Watson's view was essentially 
American, a psychology consistent with the [pioneer and 
democratic] belief in necessity of struggle for survival" 
p. 288). 

Radical Behaviorism is today antiquated, on two scores, 
(a) Its adherents, in the pursuit of their own objectives, 
have found it increasingly necessary to make use of 
"intervening variables." And (b) the spread of interest 
in clinical psychology has, again of necessity, focused 
interest upon mind rather than upon body, upon dis- 
turbances of consciousness rather than upon questions of 
biological adaptation. As Boring observes: 

Behaviorism was itself too unsophisticated to last. It has 
now given place to positivism or operationism or whatever 
one prefers to call the newest psychological objectivism. The 
operationist argues that all the data of psychology, including 
the data of consciousness, are to be defined by the operations 
which are used to observe them. You can know nothing 
more about mind than you can find in the evidence for the 
existence of mind. This movement gets its sophistication 
from the logical positivism of the Vienna Circle and from 
the operational physics of P. W. Bridgman, but this is not 
the place for its full consideration. It is sufficient here to 
point out that the epistemology of operationism was already 
implicit in the faiths of behaviorism, functional and capacity 
psychology, the basic American psychological faith (p. 288). 

It is not the purpose of the present paper to suggest 
that this faith, this ''basic American psychological faith," 
has been completely misplaced or entirely unfruitful. 
The present author (Mowrer, 1960a); has spent the 
past several months reviewing the research and theoretical 
literature to which this faith has given rise in the field 
of learning; the results are undeniably impressive. The 
question is whether this faith is as broad, as inclusive, 
as far-reaching as it ought to be. 

Functional psychology becomes the study of the organism 
in use. Functional psychology is thus practical through and 
through in the way that Darwin's theory was the greatest 
practical theory of living that has ever been put forth (Boring, 
1950, p. 277). 

Here, then, is the crux of the issue. Is it indeed true 
that mind is designed to serve the body (which is pre- 
sumably what is meant here by "practicality")? Or is 

6 The Crisis in Psychiatry and Religion 

there a reciprocal relationship of some sort, in which the 
body must become obedient, even subservient to mind? 
One hesitates to ask this question because of its clearly 
anachronistic ring. Religion has always insisted that soul 
is more important than body, that the flesh should be sub- 
jugated by the spirit. And the *'old psychology," against 
which Functionalism and Behaviorism were so strenuously 
— and not without reason — rebelling, was based upon 
presuppositions closely akin to those of theology. Boring 
calls attention to "the influence of seventeenth century 
theology upon Descartes, an influence abetted by lan- 
guage." In French Vame, he notes, may be interpreted 
either as mind or soul, and the same is true of the Ger- 
man word, Seele. Since one does not attribute a *'soul" 
to animals, there was, then, a tendency to deprive them 
of "mind" (and consciousness) as well. 

The Darwinian theory, on the contrary, asserted the exist- 
ence of continuity between man and animals, continuity in 
all respects, mental as well as physical, since man is believed 
to be derived from animals by continuous change (Boring, 
1950, pp. 284-285). 

There is no doubt that much has been accomplished 
by the Darwinian, the organic, the mechanistic approach 
to mind. Many things of a psychological nature are now 
clearly and systematically understood in objective terms 
which were simply given, seemingly unanalyzable, in a 
psychology which made conscious experience all impor- 
tant. And with the physical models and thought forms 
provided by modern servo theory, it seems that we have 
by no means yet fully exploited or exhausted what can 
be done along these lines. But we must return to the 
thesis that all is not well with contemporary psychological 
science. To assume otherwise, in face of the manifest 
realities, is hazardous — and a betrayal of the ideals of 
science itself. 


The fact, the decidedly inconvenient but seemingly 
inescapable fact, is that man must be concerned with 
the struggle for psychological survival, as well as with 

Philosophical Problems in Counseling 7 

physical, organic, bodily survival. Indeed, he has already 
succeeded so well in the latter respect that his very 
success now constitutes one of our most pressing dilem- 
mas (waning natural resources and a world population 
that is increasing at the net rate of 75,000 persons per 
day) [cf. also Chapter 13]. But in the struggle for^ 
psychological survival, we seem to be groping for first 
principles. Whether, in absolute terms, there is more 
"mental disease" in this country than formerly is perhaps 
open to question; but relatively — relative, that is, to 
physical illness and incapacity — psychological and emo- 
tional disorders are so clearly in the lead that it is now 
trite to refer to them as "the nation's number-one health 
problem,'' the plague of modern times. 

We have remarked upon the considered skepticism 
and disillusionment of our bright young men in clinical 
psychology. And we have also seen what some of our 
more mature writers have to say about the field of 
psychotherapy. Moreover, under the urgency of the grow- 
ing popular demand that "something must be done," 
men in positions of responsibility and public trust have 
openly declared that if a new "breakthrough" does not 
soon come in the field of mental health, they will be 
forced, by the very nature of their social obligations, 
to start supporting research and training outside the 
acknowledged professions of psychiatry, clinical psychol- 
ogy, social work, and psychiatric nursing — not, perhaps, 
with much conviction but out of sheer desperation.^ 

The professions just mentioned have, by and large, 
pinned their hopes to psychoanalysis. This body of theory 
and practice needs no criticism here; the logic of events 
seems to be making purely verbal objections gratuitous. 
While the present writer has previously joined in the 
attack upon psychoanalysis, he now has no zest for further 
criticism. If one can correctly interpret the course of 
on-going developments, they clearly signify the failure 

^ Since the above was written, the National Institute of Men- 
tal Health (of the U. S. Public Health Service) has approved 
several "pilot study" grants for training of personnel in psy- 
chopharmacology, neurophysiology, sociology, theology, and 
other "peripheral" professions. Note also the work of the newly 
established Joint Commission on Mental Illness and Health. 

8 The Crisis in Psychiatry and Religion 

of this movement, leaving one only to say, perhaps, 
''More's the pity. Things would have been so much 
simpler, so much easier if Freud had only been right!" 
But if reality is not as he thought, then the sooner and 
more completely we recognize his errors the better. 
/j We need hardly remind ourselves that Freud was 
!*/ strongly influenced by the same forces that shaped the 
"new psychology" in America. We know, by his own 
repeated statement, that as a youth Freud read and 
greatly admired Darwin, and the influence is evident: 
for Freud, neurosis was the result of cultural (moral, 
religious) interference with normal physiological (in- 
stinctual) processes. The mind, if dominated by certain 
mistaken social values, may cease to serve the body and 
I obstruct its functions. The body then protests and 
I retaliates. T/icrt is ''neurosis," and the crux of Freudian 
\ psychopathology. Here we see Functionalism and Scien- 
' tific Materialism applied to Twentieth-Century man's 
most pressing problem. Are they indeed so eminently 
\;j practical? Are they really the greatest ''theory of living 
that has ever been set forth"? 

Let us not sell them short. Functionalism and Scien- 
tific Materialism provided the intellectual climate and 
basic premises which have made possible unprecedented 
advances in our knowledge of animal behavior and have 
laid the foundation for attacking some distinctively 
human problems — for example, the psychology of lan- 
guage — ^with new insights and confidence (Mowrer, 
1960b). Perhaps we merely lack patience. Give them 
time and opportunity to demonstrate their ultimate 
potency. Indirect report has it that one of the few re- 
maining extreme Behaviorists has recently begun re- 
searches with severely disturbed psychiatric patients and 
that the therapeutic results already obtained are remark- 
able. All power to this project. But sanguine hopes were 
expressed decades ago for what the New Psychology 
would do for the field of mental hygiene (Angell, 1907). 
It has not, sad to say, borne the hoped-for fruit. Let no 
hunch go neglected here. But neither history nor the 
contemporary scene provides grounds for much confidence 
that the solution, if solution there be, lies in that direc- 
What other alternatives are there? 

Philosophical Problems in Counseling 


Is it, then, improper to explore the possibility that the 
body must serve the mind, as well as mind serve the 
body? While mind presumably evolved because, as Boring 
^serves, it ''saves" the body, yet once evolved it appears 
that mind has it s_owrispecial needs, its own conditions 
[oT_jm}D^ii2l^.Jts_joym^^^g^ culture. And we must 

then ask, How and inwhaFsense the body can serve and 
"save" the mind? 

For psychologists, this is a dangerous question to 
consider; for if it is answered at all affirmatively — if we 
Donclude that body must serve mind, it brings us imme- 
diately into a domain where we are by no means authori- 
ties, but rank amateurs. Religion has steadfastly said, 
save in its weaker moments, that conduct must be guided 
by the needs of the spirit as well as those of the body. 
/\nd some of the best minds of all ages have devoted 
themselves to working out patterns and precepts of con- 
duct which are "holy" (integrative, redemptive, health- 
giving, therapeutic). Here, not only are we psychologists 
relatively uninformed; we have sat, alas, in the seat of 
scorn and have barriers of pride and deep bias to over- 
come before we can become even apt students, much 
less teachers and trustworthy leaders in this area. 

Let it be at once granted that religion has sometimes 
taken an extreme and indefensible position in this con- 
nection. Sometimes it has said that not only must the 
body be subservient to mind and soul; the body must 
also be despised and continually chastized. No greater 
or more clarion voice ever cried out against this perver- 
sion than that of Martin Luther. Said he: 

No Christian should despise his position and life if he is 
living in accordance with the word of God, but should say, "I 
believe in Jesus Christ, and do so as the ten commandments 
teach, and pray that our dear Lord God may help me thus 
to do." That is a right holy life, and cannot be made holier 
even if one fast himself to death. . . . 

Huss has been burned, but not the truth with him (Stuber, 
1952, p. 213). 

Although Luther successfully launched the Protestant 
Reformation, the philosophy of asceticism is still alive 

10 The Crisis in Psychiatry and Religion 

within but under debate by the Roman Church. Gold- 
brunner (1955), an ordained priest and scholar well 
known in Europe, has recently stated the growing senti- 
ment within the Church against asceticism, in a most 
interesting and energetic manner. But we need not here 
pursue his argument in detail. Asceticism is clearly in 
retreat. Moreover, it is not indigenous to or an intrinsic 
part of the Christian *Vay" or life style. The founder 
of the movement did not say, Do not eat at all. He even 
taught his students and followers to give thanks for their 
"daily bread.'* But he did insist that man does not live 
by bread alone. And he spoke of a more abundant life, a 
life of the spirit, which was to be achieved by relatedness, 
reconciliation, fellowship — with man and God. What 
^ does it profit a man, he asked, if he gain the whole 
^ world but lose his mind, his soul? Truly a life with a 
permanently disordered mind ("unredeemed soul") is a 
^--"life worse than death." In insanity there is physical, 
^"biological survival; a compassionate society sees to that. 
^' But to what avail? 

^ It has been common for us objectivists to psychologize 
^ religion, to write about the "psychology of religion." 
And Freud (1928), as we know, went a step further 
and reduced it to a form of psychopathology, often 
relatively benign but sometimes thoroughly malignant. 
•^/TIow helpful, how constructive, how genuinely scientific 
J have such forays been? Psychoanalysis as a movement 
;| is in trouble. Church attendance in this country, by 
7 contrast, is rapidly increasing, well beyond population 
/ growth. In other words, Freud's "reality principle" ap- 
pears to be doing less well than the "illusion" with such 
an unpromising future. Perhaps Freud was still, in one 
sense, right: maybe he was wrong only in his estimate 
of man's growing capacity to live without illusion. Or, 
can it be that he himself misperceived "reality"? 

Under the sway of Darwinian thought, we practical, 
functional, behavioristic psychologists have tended to 
dismiss religion as irrelevant to both the scientific and 
human enterprise, or, with Freud, to regard it as actively 
inimical to soundness of body and mind alike. We have 
analyzed, psychologized, pathologized religion, ignoring 
the possibility that it is, in and of itself, a psychology, 
souMogy of the profoundest sort. By our own stated 

Philosophical Problems in Counseling 11 

premises, our science is a species, a derivative of biology, 
physiology, even physics. Religion represents man's at- 
tempt, through the ages, to meet mind on its own terms. 
Can this be a truer, more genuine psychology than our 

How to decide? The antiquity and continued vitality 
of religious thought and action may be said to bear upon 
the question. Freud argued to the contrary. It was some- 
thing, he said, that had simply become lodged, adven- 
titiously, in man's "unconscious" and was perpetuated 
like some congenital physical weakness or disorder. But 
contemporaneous, as well as historical, evidence suggests 
that religion, as an institution, has survived for the reason 
that it often has unique psychological survival value for 
the individual. That it gave early Christians the capacity 
to handle not only the ordinary conflicts and tensions 
of life but enabled them to persevere in the face of and 
eventually to overcome the most powerful political op- 
position on the face of the earth is established history. 
And in our own time the evidence from case-histories 
of "brain washing" successfully withstood on religious 
grounds is steadily growing (see, for example, Perkins, 

The English psychiatrist, Ernest White, (1955, p. H) 
takes this position: 

One often finds that questions do not admit of a clear 
answer because the assumptions on which they rest are false. 
For example, after an address had been given on the subject 
of Psychology and Religion, a member of the audience asked 
why it was that so many more neurotic people were found 
inside the churches as compared with people outside. Now 
it is not possible to answer such a question unless it has 
been first demonstrated by special investigation that there 
are in fact more neurotics in proportion among churchgoers 
than among the general population. As far as I know, no 
such investigation has been made. 

Preliminary attempts, apparently not known to White, 
have been made in this country to get empirical evidence 
on this point, with results that give church members 
a comparatively clean bill of emotional health (Link, 
1936, Chap. 1 and p. 99). But much more searching 
study of the issue, at the empirical level, is obviously 
needed. From one point of view, no neurotic individuals 

12 The Crisis in Psychiatry and Religion 

at all should be found in a church-going population. If 
religion offers an assured salvation, this might seem to 
follow axiomatically. But it would be absurd to condemn 
hospitals, as institutions of physical remediation, because 
one finds so many sick people in them. The appeal of 
religious institutions has always been addressed to "poor, 
sick souls," and Christ himself said that he did not come 
to call the righteous. Hence, a study which would be 
faithful to both sides of the argument needs to be care- 
fully interpreted, as well as meticulously impartial. 

COMMON ground: the study of interpersonal 


It has already been noted that psychologists, for reasons 
given, have been hard to interest in religious psychology, 
as opposed to objective psychology and psychoanalysis. 
Indeed, as Roberts (1956) has observed, "A psycholo- j 
gist who is suspected of being religious is at once under 
suspicion of scientific incompetence," although the same 
suspicion does not attach itself to a physicist, a chemist, 
or an engineer. But there are signs of change. A number 
of national organizations (typified by the National Acad- 
emy of Religion and Mental Health ) have recently sprung 
up with the avowed purpose of unifying, or at least, j 
relating, psychology, psychiatry, and religion; and, within i 
the American Psychological Association itself, there is s 
now a "special interest group" in this area which has 
held meetings at our two most recent conventions. 

Perhaps most auspicious of all is the fact that so many 
psychologists are now turning their research interests 
toward problems which have long been of concern to 
religious and church leaders, notably problems having 
to do with social affiliation and what Foote and Cottrell 
(1955) have aptly termed interpersonal competence. 
Here it is inevitable that psychologists should encounter 
many of the same realities as have interested religious 
thinkers and practitioners throughout history. This point 
is well illustrated in a paper recently published by Corsini i 
and Rosenberg (1955). These writers did a sort of in- ' 
formal factor analysis of the contents of some 300 con- 

Philosophical Problems in Counseling 13 

temporary books and articles on the subject of group 
psychotherapy and emerged with "ten classes of mechan- 
isms" commonly emphasized therein. 

All of these mechanisms, or principles, need not be 
considered here; but the two which head Corsini and 
Rosenberg's list are these: 

Acceptance. This statistically most frequent concept was 
taken to mean respect for and sympathy with the individual. 
Acceptance implies belongingness, a warm, friendly, com- 
fortable feeling in the group. 

Altruism. Closely related to acceptance but in addition in- 
volving wanting to do something for others is the mechanism 
of altruism. The essence of this mechanism is the desire to 
|help others (p. 107). 

re these two mechanisms so salient because the 
au^ors of the works thus analyzed have a basically 
religious orientation? Or have the authors, with an 
initially neutral or perhaps even unsympathetic attitude, 
empirically rediscovered the therapeutic potency of ''fel- 
lowship" and "charity"? 

Whatever the answer to this question, the fact stands 
out that, increasingly, psychologists are joining psychia- 
trists and clergymen in looking for both the cause and 
cure of personality difficulties in the social, interpersonal, 
moral, or "spiritual" realm. But what of those most 
welcome advances recently made in drug therapy? As 
May (1955) has cogently observed, these drugs — merciful 
as they are for use with persons in terror states and agita- 
tions — leave essentially untouched the problem of pre- 
vention and personality reorganization. 

In our neighbor discipline. Sociology, there has long 
been a tendency to view mind, or "self," as much more 
of a social than biological phenomenon. Here the influ- 
ence of Mead (1934) is already strong, and becoming 
increasingly so. Thus the confluence of thought noted 
above gains yet another tributary. 

The centrality of religious tradition and practice is 
obvious here. But there was a manifest difficulty. Let one 
highly placed within organized religion, itself, speak on 
this score. Says Rev. James A. Pike (1954), Dean of the 
Episcopal Cathedral of St. John the Divine, in New 

14 The Crisis in Psychiatry and Religion 

The Biblical writers are, by and large, short on concepts, 
long on concern as to the human situation. The early Church 
carried this tradition forward: the articles of the Creeds are 
not just intellectual speculations. They are affirmations 
wrought out in the fire of personal and corporate experience 
and found to be abiding answers to perennial questions 
which affect the nature and direction of human life under 
God (p. 6). 

The Biblical writers emphasize, not "theory," but 
testimony. Make an "investment," "experiment," "try it" 
say characters in Lloyd Douglas' novels. Or, in Pike's own 
colorful phrase, in order to find out you have to "bet your 
life." Prove all things, said the Apostle, Paul.^ Perhaps 
psychologists can ultimately help provide a clearer, more 
naturalistic, more rational explanation and understanding 
of these pragmatic varieties. This would be an undertak- 
ing of first-rate importance and magnitude. But before 
psychologists and religionists can thus creatively collab- 
orate, both must change from what they have earlier 
been. Contemporary religious writers now seem increas- 
ingly aware of errors into which religion fell during the 
nineteenth century. One of these errors was obstinacy in 
accepting the clear evidence for organic evolution. But 
ever more grievous, perhaps, was a later willingness to go 
too far in accepting the psychological view of man 
seemingly dictated by evolutionary considerations. In the 
introduction to Alexander Miller's recent book, The 
Renewal of Man, Reinhold Niebuhr (1955) has said: 

Christianity has tried rather too desperately to accom- 
modate itself to modernity. In its desperation it frequently 
sacrificed just those points in the Christian Gospel which 
would throw light on mysteries which modern learning left 
obscure (p. 8). 

The present age, though incredulous toward the chief af- 
firmations of this faith, is bound to find it more relevant 
than previous ages, which conceived their own schemes of 
salvation. Our age is the inheritor of the confusion and the 
evil which proceeded precisely from these schemes of salva- 
tion (p. 9). 

'^Walters (1955) has pertinently observed that Freud, 
while condemning religion, took the same position in 
holding that no one could properly evaluate or criticize 
psychoanalysis who had not himself had such an expe- 

Philosophical Problems in Counseling 15 

There are many indications, over and beyond those 
cited in this paper, that we are now well into a religious 
reformation comparable in scope and significance to that 
of four hundred years ago. Institutionalized religion had 
stagnated. Within the past century, science in general 
and biological science in particular, threatened its very 
life. Now religion appears to be recovering and, in that 
process, has gained new vitality and validity. What are 
the implications of this unexpected turn of events for 
psychology? Although we may feel uncertain of the 
answer, we cannot complacently ignore the question. 



There is clear indication that the theory of organic evo- 
lution has profoundly and pervasively influenced American 
psychology during the past three-quarters of a century. 
Mind, rather than being something to be studied in its 
own right, has been conceived as "an organ of adapta- 
tion," an appendage of the body instrumental to the 
achievement of bodily ends. 

Thanks to the stance of the "New Psychology" (Func- 
tionalism. Behaviorism), it has proved possible, for the 
first time, to develop a systematic, essentially objective 
understanding of many basic psychological processes. 
Behavior theory is now a relatively unified assembly of 
fact and principle which commands respect in any scien- 
tific company. 

Nor was the influence of Darwinian thought restricted 
to psychology in this country. Equally potent was its 
impact upon Freud and the school of psychopathology 
which he founded. Here the "neuroses," both mild and 
severe, were seen as springing from the fact that the 
mind, under the sway of unfortunate or misdirected 
social experience, has, in effect, turned against the body 
and is no longer ministering to its needs. 

But there is increasing evidence that neither the 
original Freudian formulation nor its attempted restate- 
ment in terms of contemporary behavior theory gives us 
the answer to some of man's most profound, and uniquely 
human, problems. Today we are probing the future 
(through research) and searching the past, through 
historical studies, for leads to a better and psychologically 

16 The Crisis in Psychiatry and Religion 

more abundant life. What do we find? Growing indica- 
tion that the human mind, in its towering complexity^ 
long ago reached the point where it has its own special 
conditions for ''survival/' conditions which are not only 
different from those of physical comfort and well-being 
but which may on occasion be in conflict therewith. 
Both ongoing researches and a re-examination of history 
point to the conclusion that religious precepts and prac- 
tices, over the centuries, have grown up largely in response 
to man's unique psychological needs and that there are 
insights and prescriptions for action here which con- 
temporary man may, with profit, reconsider. 

Such a reconsideration seems now to be well under 
way, mainly by theologians, naturally enough, but also, 
and to a surprising degree, by psychiatrists. Psychologists, 
in their increasing interest in group psychotherapy, are 
also showing a new awareness of social values; and several 
interprofessional groups have recently been formed for a 
concerted confrontation of the problem at the level of 
research and practice. 

The burden of the present paper is that it will greatly 
hasten this readjustment if we can succeed in seeing the 
proper relationship between man's needs for physical 
and psychological survival and can transcend the tacit 
assumption that mind is merely servant of the body and 
that, if it serves this master well, it will itself neces- 
sarily prosper. Long ago we were reminded that man 
does not live by bread alone; and it is none too early 
for us to turn our attention to the identification and 
better understanding of this ''something more." 

Changing Conceptions 
of the Unconscious* 

Perhaps more than anything else, the feature of Freud- 
ian psychoanalysis which has given it an air of mystery 
and its practitioners a presumption of esoteric knowledge 
and power is its doctrine of ''The Unconscious." In the 
present chapter we see that this doctrine is in process of 
radical revision and re-evaluation, along lines more con- 
genial to common sense and traditional moral and reli- 
gious ideology. Now it is possible, in terms of this evolv- 
ing conception of psychopathology, for the average per- 
son not only to know something about such matters but 
also to do something, i.e., take initiative and responsibility 
in their prevention and correction. 

In the preceding chapter, we have postulated that per- 
sonality disturbance can be adequately understood only 
in an interpersonal, social, moral matrix. But in order for 
this conception to hold, we must also be able to account 
for the purely internal, intrapsychic — as well as external, 
interpersonal — phenomena which characterize those 
states we call neurosis and psychosis. The critical con- 
sideration here is the way in which that remarkable 
agency known as conscience operates. If our present 
analysis is correct, personality disturbance is less an ''ill- 
ness'' than an effort, on the part of "The Unconscious," 
to bring about personal change and growth. Can it be 
that much of our current therapeutic and preventive 
endeavor in this area is ineffective {even harmful) be- 
cause it is predicated on a contrary set of assumptions? 


In a field which otherwise abounds with confusion and 
uncertainty, there is one rock-ribbed fact: namely, that 
the hallmark of psychopathology is a feeling, on the part 
of the afflicted individual, that he is having experiences 


18 The Crisis in Psychiatry and Religion 

which he himself did not plan or "will" and which he 
does not at all understand. The ubiquity of this observa- 
tion, therefore, makes entirely plausible the impression 
that personality disturbance is somehow associated with 
the presence and activity of an alien, dissociated, un- 
known, and ominous force or set of forces within the 
personality which is currently known as The Unconscious, j 
But beyond this point, there is scant agreement. What 
is in the Unconscious? How did it get there? What is it 
trying to do? Should it be assisted or opposed? These 
are questions to which, in our time, we have had no 
assured answers. The purpose of the present paper is to 
look at these questions and at the overall problem of psy- 
chopathology in historical perspective and to suggest, ten- 
tatively, a way of reinterpreting and, hopefully, integrat- 
ing the presently discordant array of fact, theory, and 


From the point of view of this inquiry, 1915 was an 
eventful year. In that year Freud published two papers, 
one on ''Repression" and the other on 'The Uncon- 
scious" which epitomized his theoretical system or so- 
called "metapsychology" and which set forth ideas that 
have gained world-wide currency and influence. In the 
second of these papers, Freud argued persuasively that 
the concept of mind or mental activity should not be 
confined to those processess which are at any given mo- 
ment conscious or likely to become conscious, but should 
instead include forces or processes which are unconscious 
but which are not, for that reason, to be thought of as 
dormant or ineffectual in determining experience and 
action. He said: 

In many quarters our justification is disputed for assuming 
the existence of an unconscious system in the mind and 
for employing such an assumption for purposes of scientific 
work. To this we can reply that our assumption of the 
existence of the unconscious is necessary and legitimate, and 

* Prepared and delivered, by invitation, as a lecture at the 
1958 meeting of the American Personnel and Guidance Asso- 
ciation, in St. Louis, and subsequently published in The Jour- 
nal of Nervous and Mental Diseases, 1959, 129, 222-232. 

Changing Conceptions of the Unconscious 19 

that we possess manifold proofs of the existence of the un- 
conscious. It is necessary because the data of consciousness 
are exceedingly defective; both in healthy and in sick persons 
mental acts are often in process which can be explained only 
by presupposing other acts, of which consciousness yields no 
evidence. These include not only the parapraxes and dreams 
of healthy persons, and everything designated a mental 
symptom or an obsession in the sick; our most intimate daily 
experience introduces us to sudden ideas of the source of 
which we are ignorant, and to results of mentation arrived at 
we know not how. All these conscious acts remain discon- 
nected and unintelligible if we are determined to hold fast 
to the claim that every single mental act performed within 
us must be consciously experienced; on the other hand, they 
fall into a demonstrable connection if we interpolate the 
unconscious acts that we infer. . . . We become obliged 
then to take up the position that it is both untenable and 
presumpfeious to claim that whatever goes on in the mind 
must be known to consciousness (1915b, p. 99). 

While Freud did not hold that the unconscious mind 
is created solely by repression, he did hold that repression 
is a potent source of unconscious energies and a prime 
cause of psychopathology. The mere fact that an idea 
or impulse has been banished from consciousness does 
not at all mean that it has lost its dynamic properties; 
and its continued striving for recognition and expression 
constitutes, according to Freud, the principal basis of 
anxiety and ensuing symptom formation. More specifically 
Freud believed that the mental processes which are most 
likely to undergo repression are the instinctual forces of 
sexuality and hostility and that repression occurs, typi- 
cally, v^^hen the ego, under the sway of socially instilled 
moral precepts, rejects and condemns these impulses. 

Two forms or stages of repression were to be distin- 
guished. There was, first of all, what Freud called primal 
repression^ *'a first phase of repression, which consists in 
a denial of entry into conscious of the mental (idea- 
tional) presentation of the instinct" (1915a, p. 86). But, 
continued Freud, "repression does not hinder the instinct- 
presentation from continuing to exist in the unconscious 
and from organizing itself further, putting forth deriva- 
tives and instituting connections" (p. 87). 

The second phase of repression, repression proper, con- 
cerns mental derivatives of the repressed instinct-presentation, 

20 The Crisis in Psychiatry and Religion 

or such trains of thought as, originating elsewhere, have 
come into associative connection with it. On account of this 
association, these ideas experience the same fate as that 
which underwent primal repression. Repression proper, there- 
fore, is actually an after-expulsion (pp. 86-87). 

Therefore, continued Freud, 

The process of repression is not to be regarded as some- 
thing which takes place once for all, the results of which 
are permanent, as when some living thing has been killed 
and from that time onward is dead; on the contrary, repres- 
sion demands a constant expenditure of energy, and if this 
were discontinued the success of the repression would be 
jeopardized, so that a fresh act of repression would be neces- 
sary. We may imagine that what is repressed exercises a con- 
tinuous straining in the direction of consciousness, so that the 
balance has to be kept by means of a steady counter-pressure. 
A constant expenditure of energy, therefore, is entailed in 1 
maintaining a repression, and economically its abrogation 
denotes a saving (pp. 89-90). 

The resolution of a conflict between instinct and moral 
scruple by means of repression is thus unstable and debil- ^ 
itating; and from this it followed, reasonably enough, 
that the sovereign aim of therapy was to undo repression 
and permit sexual and hostile impulses to find freer, less 
encumbered routes to gratification. Such a program called 
upon the psychoanalyst to align himself with and to speak 
for the instincts, in opposition to the moral or pseudo- 
moral forces within the personality which have instituted 
the repression. Hopefully, these forces can be held back 
by the combined strength of the patient and the analyst 
so that the blocked instincts can find more adequate ex- 
pression; and, more than this, it was believed that, by 
working through the so-called transference neurosis, the 
severity and irrationality of these forces might be perma- 
nently lessened so that, following analysis, the individual 
could function, more naturally and more comfortably, 
without the analyst's continued presence or assistance. 

For all practical purposes, Freud's theory was here- 
with complete. In the 1915 papers he still regarded anx- 
iety as a direct "transformation" of the repressed im- 
pulses, a view which was to be somewhat modified in his 
"second theory" of anxiety. And he was still to introduce 
the term, superego, although he was already speaking of a 

Changing Conceptions of the Unconscious 21 

"censorship" function (1915b, p. 105). But, in broad 
outline at least, the theory was fully developed and was 
later to be changed in only minor ways. With his special 
gift for graphic similes, Freud summarized his discussion 
of repression thus: 

In general, repression of an instinct can surely only have 
the effect of causing it to vanish from consciousness if it had 
previously been in consciousness, or of holding it back if it 
is about to enter it. The difference, after all, is not impor- 
tant; it amounts to much the same thing as the difference 
between ordering an undesirable guest out of my drawing- 
room or out of my front hall, and refusing to let him cross 
my threshold once I have recognized him (1915a, p. 91). 

To which we need only add that the unwelcome 
"guest" does not, after his ejection, quietly go away, but 
instead continues to try to find other means of re-entry 
and, much in the manner of a restless ghost, haunts the 
abode which it feels to be rightfully its own, to the dis- 
may and discomfiture of the dominant occupant. 



In his recently published three-volume biography, 
Ernest Jones defends Freud against the common surmise 
that he was a difficult man to get along with and argues 
that those who were first attracted to but then, sooner or 
later, turned against him were themselves unstable or of 
doubtful character. On the other hand, Ira Progoff, in 
his book The Death and Rebirth of Psychology, suggests 
that the difficulty was not basically one of ''personality" 
at all, on either side, but was rather ideological. At least 
in the case of Adler, Jung and Rank the final rupture, 
Progoff holds, came because these men were keenly aware 
of incongruities between the clinical facts and Freud's 
theories and were compelled to withdraw from the orbit 
of his influence in order to be true to their own develop- 
ing ideas and convictions [cf . Chapter 1 3] . 

Among the less well known but most interesting of 
those men who first joined and then left Freud was 
Wilhelm Stekel. In his autobiography, published in 1950, 
Stekel gives the details of his break with Freud, over ap- 
parently personal and practical matters; but a study of 

22 The Crisis in Psychiatry and Religion 

StekeFs other published works reveals a deep and, for our 
purposes, highly significant theoretical deviation. 

In the preface of a book first published in German 
(1938) and later translated into English (1950), with 
the title Technique of Analytical Psychotherapy, Stekel 
indicated just how complete his break with Freud had 
been by remarking: 

I contend that orthodox analysis has reached a crisis which 
betokens that the end is near, that collapse is approaching. 
Clinical records of its successes count for nothing, now. The 
happy days of interminable analyses are gone for ever (p. 
xxii ) } 

The medical analysis of tomorrow will have to separate 
the wheat from the chaff, to combine the various doctrines 
and schools into an organic whole, and to establish an un- 
dogmatic, unprejudiced psychoanalysis. Then the physician 
will become the educator of mankind (p. xxiv). 

The seemingly hasty and bombastic way in which 
Stekel wrote undoubtedly kept him from being taken as 
seriously as he otherwise might have been; but in light of 
subsequent developments, we find a genuinely prophetic 
element in his work. In Technique of Analytical Psy- 
chotherapy there is a most remarkable chapter entitled 
''Diseases of the Conscience" which does not unfold at 
all the way one might expect it to. Freud — implicitly in 
his early writings and, later on, quite explicitly — ^held 
that repression, as the primal pathogenic act, occurs be- 
cause the individual's conscience or superego is too severe, 
unrealistic, and irrational. Therefore, when Stekel refers 
to "diseases of consciences," one might well expect him 
to have in mind much the same assumptions as had 
underlain Freud's conception of the so-called neuroses. 

Instead, Stekel's attitude toward conscience is respectful 
and positive; and by ''diseases of conscience" it is quickly 
apparent that he means diseases or disturbances which 
are caused by a careless disregard or active defiance of 
conscience and its urgings. He says: 

My experiences as a psychotherapist have convinced me 
that many nervous disorders are "diseases of the conscience." 
Of course it is far from easy to recognize conscience under 

* Cf . Freud's own paper, "Analysis terminable and intermin- 
able" (1937). 

Changing Conceptions of the Unconscious 23 

the manifold disguises it can assume. But there are stereo- 
typed ways by which we can be aided in exposing the wiles 
of conscience, and in discovering when parapaths are play- 
acting — for they often persuade themselves that they have 
no conscience, and take refuge in an ostensibly organic 
disease in order to escape the torment of self-reproach. Some- 
times, however, such a patient will during the analysis have 
a bad "fit of conscience," bursting into tears, which may 
continue for as much as half an hour before the releasing 
avowal comes (p. 320). 

Stekel, as was his literary practice, then plunges into a 
series of interesting and highly dramatic case histories 
which we cannot review here. But in summary he says: 

All these cases show how grave a blunder we should make 
were we to accept the one-sided view of those Freudians who 
hold that lack of sexual gratification is the exclusive cause of 
psychogenic troubles. In Cases 69, 70, and 71, free rein was 
given to the sexual impulse, which was adequately gratified, 
and yet intractable illness supervened, whereas during the 
periods of abstinence the symptoms disappeared because the 
conflict-engendering relations were broken off and the con- 
science was at rest (p. 324). 

I have had many cases of the kind, but have merely 
selected a few to show that parapathic disorders may be 
diseases of the conscience. The patient suppresses his re- 
morse, tries to drown the voice of conscience, and feigns 
immunity. Nature takes vengeance (p. 327). 

As long as Freudian theory was in the ascendancy, it is 
little wonder that Stekel's views remained unknown and 
without influence. But in 1956 a book entitled Progress 
in Psychotherapy was published in this country (under 
the semi-official auspices of the American Psychiatric As- 
sociation) in which many of the forty-odd contributors 
expressed mounting doubt and disillusionment concern- 
ing orthodox psychoanalysis and in which there is a 
chapter, by Lowy and Gutheil, which is devoted to an ex- 
position and advocacy of Stekel's so-called "active ana- 
lytic" approach to psychotherapy. Here these authors say: 

Stekel's debut as the originator of an independent psy- 
choanalytic technique was manifested by his thesis that every 
< neurosis — or as he called it "parapathy" — is based on a con- 
Iflict between the principles of morality and loyalty and the 
impulses and tendencies to the contrary. This simple, clini- 

24 The Crisis in Psychiatry and Religion 

cally evolved formula was then not as self-evident as it has 
become subsequently. . . . 

Although essentially a practitioner, Stekel also made a few 
important contributions to the theory of psychoanalysis. Long 
before Freud's discovery of the superego, Stekel spoke of the 
-'moral ego" as a factor in the psychogenesis of neurosis. He 
//maintained that a neurotic reaction can ensue not only 
i through the repression of moral tendencies; that on certain 
*• occasions, even if the individual appears to be ready to give 
/ in to his antimoral and antisocial desires, the moral trends 
I may assert themselves against the patient's will. He [Stekel] 
quoted the case of a traveling salesman who was always 
potent with his wife, while being impotent with other 
women. Cases of this type were considered proofs that 
neurotic symptoms may be serving the patient's unconscious 
moral needs, that they may safeguard the individual's in- 
trinsic morality (p. 136). 

As ProgofI points out in the book previously cited, 
Adler, Jung and Rank, in abandoning the classical psy- 
choanalytic position, all moved in the direction of a 
greater emphasis upon the social, moral, or ''spiritual" 
factors in neurosis; but this trend was certainly outstand- 
ing in Stekel, as the foregoing quotations indicate. 

Also, about the same time and apparently quite inde- 
pendently of any direct connection v^ith Stekel, an 
American writer by the name of Anton T. Boisen was 
formulating a very similar point of view. As a result of a 
brief psychotic experience of his own and of subsequent 
participation in the Rockefeller-supported study of schizo- 
phrenia at the Worcester (Massachusetts) State Hos- 
pital, Boisen became convinced that psychosis represents 
a character crisis, from which an individual may move 
either in the direction of deterioration or toward personal 
reorganization on an ethically and socially higher plane. 
Gentle, soft-spoken, and in no sense given to controversy, 
Boisen was temperamentally very different from Stekel, 
yet his ideas about psychopathology are much the same. 
In his best known book. The Exploration of the Inner 
World (1936), Boisen's views are epitomized by the fol- 
lowing excerpts. He says: 

The form of psychotherapy now most in the public eye is 
psychoanalysis. This in its aims is the exact opposite of 
faith healing. It has often been compared by its proponents 
to surgery, and major surgery at that. It is an attempt to 

Changing Conceptions of the Unconscious 25 

lay bare and bring into clear consciousness the disowned 
sexual desires and cravings which it assumes have become 
detached from the conscious self and are responsible for the 
neurotic symptoms. Its aim is to make over the harsh con- 
science and the rigid ethical standards which have led to the 
disowning of these sex cravings so as to permit of their in- 
corporation in the personality. To this end the psychoanalyst 
tries to get his patient to live through again his early ex- 
periences. The entire procedure is designed to detach the 
patient from his early loyalties in order to enable him to 
build up a new philosophy of life in which the dissociated 
cravings may be properly assimilated (pp. 243-244). 

In all my efforts [as a hospital chaplain and therapist] I 

rely upon a simple principle derived from my theological 

training which seems to me far too little understood. I refer 

jto the view that the real evil in mental disorder is not to be 

\found in the conflict but in the sense of isolation or estrange- 

\ment. It is the fear and guilt which result from the presence 

iin one's life of that which one is afraid to tell.^ For this 

reason I do not consider it necessary to lower the conscience 

threshold in order to get rid of the conflict. What is needed 

is forgiveness and restoration to the fellowship of that social 

something which we call God (pp. 267-268). 

I would furthermore [suggest] that our findings indicate 
that the sense of guilt, the self-blame and the emotional dis- 
turbance which accompany it are not themselves evils but 
atteijipts at a cure. The real evil is the failure to attain the 
level of adjustment called for in some new period of develop- 
ment and the short-circuiting of the vital energies through 
; easy satisfaction (p. 281). 

Elsewhere in the same volume Boisen, using a phrase- 
ilogy almost exactly the same as Stekel's, refers to a 
everely neurotic or psychotic person as one who ''has 
ecourse to certain unsatisfactory protective devices, seek- 
ng to suppress a troublesome conscience, until the ten- 
ion reaches the breaking point and the solution comes 
i^ith cataclysmic suddenness" (p. 78). 

Only vaguely aware of the names of Stekel and Boisen 
nd without any detailed familiarity with their writings, 
he present writer, in 1947, after more than a decade of 
icceptance of the Freudian view, took the following posi- 

^ Somewhere I have recently read that Havelock Ellis, even 
:arlier, once remarked that the problem of psychopathology 
irises, not from the unconscious, but from the unutteredl 

26 The Crisis in Psychiatry and Religion 

By way of recapitulation let it be said that we are here 
fully accepting the basic theory of Freud concerning the na- 
ture of symptom formation, i.e., that a neurotic symptom, 
so-called, is any habit which resolves anxiety but does not ; 
lessen the ultimate, realistic problem which the anxiety repre- 
sents. And we are also in complete accord with Freud's con- 
tention that repression is necessary to an adequate theory of 
anxiety; without this concept a really satisfactory account of:' 
anxiety is apparently quite impossible. But it now appears, onjl 
both pragmatic and logical groups, that Freud never suc- 
ceeded in fully apprehending the essential nature of anxiety ' 

It is not possible at this time to give at all completely the J 
evidence on which this statement is based. But what can be;' 
/ j indicated, at least briefly, is the direction in which Freud's 
/ ! analysis needs to be modified. In essence, Freud's theory 
holds that anxiety comes from evil wishes, from acts which , 
the individual would commit if he dared. The alternative 
view here proposed is that anxiety comes, not from acts 
which the individual would commit but dares not, but from 
acts which he has committed but wishes that he had not. It 
is, in other words, a ''guilt theory" of anxiety rather than an 
"impulse theory." 
^ Stated in its most concise but abstract form, the diflFerence 

'^^ between these two views is that the one holds that anxiety 
arises from repression that has been turned toward the id; 
whereas the other holds that anxiety arises from repression, 
that has been turned toward the superego or conscience (p. 

Naturally, the later discovery of the antecedent works 
of Stekel and Boisen and the privilege of personal ac- 
quaintance with Dr. Boisen have been a source of great 
personal satisfaction to the writer. But, despite the con- 
verging agreements to be found here and elsewhere in 
contemporary literature, some conceptual difficulties are 
still to be resolved. These, it so happens, have been 
neatly summarized by Sidney M. Jourard in his book. 
Personal Adjustment — An Approach Through the Study 
of Healthy Personality. Here the author says: 

Clinical experience suggests that neither Freud nor Mowrer 
is wholly correct or wholly incorrect. Rather, it can be 
found that some neurotic patients do indeed have a con- 
science that is too strict; in order to remain guilt-free, they 
must refrain from all pleasurable activities, including those 
which society condones. Other patients may be found with 

Changing Conceptions of the Unconscious 27 

the makeup which Mowrer has regarded as nuclear to all 
neurosis — they repress conscience so they can break social 
tabooes without conscious guilt. 

If we paraphrase Freud's therapeutic aim to read, "change 
the conscience in lenient directions," and Mowrer's to read, 
"strengthen the conscience, and help the person to conform 
with his conscience," we are thrust into an acute impasse: we 
find that contradictory roles are assigned to the conscience in 
neurosis, and contradictory therapeutic aims are proposed. 
This impasse can be resolved if we recognize that consciences 
are not all alike among all members of a given society. Some 
consciences are stricter than the society requires, some are 
more lenient, some are quite deviant from the social value 
system, and many are highly conflicted (p. 366).* 

This analysis seems by no means unreasonable. It does 
lot, however, accurately represent my own earlier posi- 
:ion in these matters, in that never did I hold that it was 
:he aim of therapy to strengthen or increase the severity 
)f the conscience, although this has been a common 
nispreception. All I had said was that perhaps the neuro- 
:ic's great need was to have his conscience released^ just 
IS Freud had conjectured that it was certain repressed 
nstincts that were clamoring for freer access to con- 
leiousness and a greater share in the control of behavior. 
[n neither case was it suggested or even implied that the 
repressed part of the personality needed to be strength- 
zned. Because Freud did hold that the neurotic's superego 
[leeded to be made less rigid and less severe; and because 
[ had expressed a disagreement with this position, it was 
m easy but entirely mistaken inference that I was saying 
just the reverse of this. My difference with Freud's posi- 
tion had to do, explicitly and exclusively, with the ques- 
tion of what is repressed or, in other words, with the 
direction of repression and the content of the uncon- 
scious; and I welcome this opportunity to attempt to 
clarify the issue (see Levitsky, 1960). 

In other respects. Dr. Jourard's formulation is certainly 
plausible. Consciences do vary, from infancy to maturity, 
from culture to culture, and from individual to individual 
within the same culture. The sociopath, at least by 
definition if not in actual fact, is a person with an under- 

*For a somewhat similar position, see Fenichel (1954), 
Fromm (1947) and Jung (1938). 

28 The Crisis in Psychiatry and Religion 

developed, weak conscience; and there is certainly no rea- 
son, a priori, why in other individuals conscience might 
not be excessively severe. However, it is not my wish here 
to debate this issue, either on empirical or logical grounds. 
Rather do I wish to invite attention to a different way of 
conceptualizing the whole matter of the unconscious, 
conscience, and the question of repression. 



Psychologists, despite pretentions of open-mindedness 
and scientific objectivity, have in certain respects been 
an arrogant and bigoted lot. I recall hearing a colleague, 
in the mid-19 30s, when the question of whether we 
should include History in the disciplines represented at 
the Institute of Human Relations at Yale, say that we 
were not interested in History, that we were not inter- 
ested even in the History of Science, that we were in- 
terested only in making Science. And certainly there has 
been a widespread assumption that the Future was ours 
alone. Some of us psychologists are now old enough to 
feel that we have experienced a sizeable piece of this 
Future, and we are by no means sure that we are neces- 
sarily much wiser or more efficient directors of destiny 
than were some of our forebears. Certainly the phe- 
nomena which we today call psychopathology have been 
known to mankind for a very long time; and it is by nc 
means certain that our progenitors understood or man- 
aged them less well than do we. 

Thus chastened, I, as a psychologist, have found mysell 
looking with renewed interest and respect at some of the 
great cultural and historical documents of the past; anc. 
here I have found nothing more illuminating than thai 
remarkable collection of writings known as the Ok 
Testament. The language is often metaphorical anc 
poetic; but the basic intent and content of these writing: 
can hardly be missed. And here we find, unmistakably, 
psychiatry which is at one with religion. 

Old Testament writers interpreted their own and thei: 
fellowmen's emotional anguish as a manifestation of th« 
"wrath of Cod." This idea is found in Ecclesiastes (5 
7), Isaiah (J 3, 9), Psalms (90), and elsewhere; and Jol 

Changing Conceptions of the Unconscious 29 

puts it succinctly when he says, ''Have pity upon me, 
have pity upon me, O my friends; for the hand of God 
hath touched me" (19, 21). But the theme is perhaps 
most explicitly and fully developed, in the 4th Chapter of 
Ist Daniel, in the account of the madness that beset 
Nebuchadnezzar. Being afflicted by visions and dreams, 
the King called Daniel in to interpret them for him. After 
nuch hesitation, Daniel told the King that he had be- 
:ome vain and iniquitous, and that he was going to have 
;o suffer grieviously before he found deliverance. 

And at the end of the days [of suffering and humiliation] 
I Nebuchadnezzar lifted up mine eyes unto heaven, and 
mine understanding returned unto me, and I blessed the 
most High, and I praised and honoured him that liveth 
forever, whose dominion is an everlasting dominion, and his 
kingdom is from generation to generation; and all the in- 
habitants of the earth are reputed as nothing: and he doeth 
according to his will in the army of heaven, and among the 
inhabitants of the earth: and none can stay his hand, or say 
unto him. What doest thou? 

At the same time my reason returned unto me; and for 
the glory of my kingdom, mine honour and brightness re- 
turned unto me; and my counsellors and my lords sought 
unto me; and I was established in my kingdom; and excellent 
majesty was added unto me. 

Here, it seems, are implications of a most profound 

md far-reaching kind. Here, if I understand the stories of 

ob, Nebuchadnezzar, and other Old Testament charac- 

ers, there is no intimation that psychopathology neces- 

arily involves repression; surely the very core of the prob- 

em is that God has spoken, expressed himself, touched 

he individual in question. And there is accordingly no 

ntention or need to make the unconscious conscious.* 

rhe question rather is why God and conscience have 

mitten us and what we can do about it. 

This is not to say, of course, that the now afflicted in- 

ividual may not have previously repressed conscience 

nd "denied God." The wicked are often referred to as 

hard of heart," calloused, and insensitive. And as long 

*Cf. Stekel's remark, "After thirty years' experience of 
Analysis, I no longer believe in the overwhelming significance 
If the unconscious (in the Freudian sense of that term)" 
!l938, p. xx). 

30 The Crisis in Psychiatry and Religion 

as these defenses hold, there is no manifest disturbance. 
Rather the "disease," if we may now use that term in a 
-Strictly social and moral sense, is to this point a purely 
latent one; and when conscience finally rebels and erupts, 
when, in Biblical language God's patience is exhausted, 
the individual is already grappling with a crisis from which 
he may emerge a chastened, changed, and converted 
man [see also Chapter 9]. 

Of course, in a certain limited sense one may say that 
religious leaders do attempt to make the unconscious con- 
scious, do attempt to release repressed, imprisoned, de- 
nied forces of personality. To the hard of heart, they con- 
tinually put forth a ''call to repentance," the confession 
of sin, and reaffirmation of obedience to the good and to 
the godly. In fact, it would seem that this is one of the 
main functions of regular worship on the part of the 
devout, to constantly acknowledge and correct their way- 
wardness and to grow in the "grace and admonition of 
the Lord." 

But it is surely equally, or even more importantly, true 
that remorse, contrition, and dismay often break out 
spontaneously in deviant individuals and that it is this 
state of manifest disturbance which we call neurosis or 
mental illness and which someone is supposed to "treat." 
Therefore, it would seem to be a real question as tO; 
whether efforts at making the unconscious conscious arei 
relevant. If, by the unconscious, we now mean conscience! 
and the "Hand of God," the task would seem to be 
quite the reverse, namely that of helping the individual 
find what he can do that will please God, satisfy con- 
science, and thus allow him once more to "go forth in 

Steeped as we are, in this generation, in a particulai 
form of naturalism, we do not easily assimilate either th( 
language or the thought forms of the ancient Hebrews 
but if the interpretation of psychopathology which ha: 
just been suggested be correct, its naturalistic basis is a- 
once apparent. To me it has been helpful to recall tha- 
a child can operate in either of two ways: (a) of his owi 
free will and wish or (b) under parental compulsion. By 
acting "like a big boy (or girl)," that is to say, maturely 
and responsibly, the child enjoys many privileges and feel 
and indeed is "free." But if the child "forgets" or ignore 

Changing Conceptions of the Unconscious 31 

ivhat his parents have tried to teach him, they have to 
reassert their authority, with an ensuing loss of freedom 
md self-direction on the part of the child. 

In like manner, may we not assume that an adult is 
:ree, i.e., self-determining and autonomous, only so long 
is he is good and that when he sufficiently violates the 
^rust of conscience, the latter ''takes over," perhaps far 
from gently and almost certainly with a feeling on the 
jjart of the individual that ''things are happening to me." 
Like the parents of an earlier day, conscience thus de- 
prives the individual of his freedom and will restore it 
|)nly when he has shown that he can again be trusted, 
rhus, the objective of therapy is not to "make the un- 
;onscious conscious." If the view just indicated is valid, 
:he very root of the difficulty is that the unconscious 
[now understood as conscience) is all too much in evi- 
ience — and the objective is to get it to subside, retreat, 
elax; and this it will presumably do only when the ego 
)r autonomous part of the personality has redeemed 

I Religion, in its most vital and significant form, has 
ilways been intent upon saving "lost souls," i.e., in help- 
ng individuals regain their sense of peace and freedom 
hrough a return to responsible living, integrity, and 
:oncern and compassion for others. This, it seems, is 
'therapy" of the most profound variety; and it is perhaps 
lur great misfortune that this conception is today ac- 
epted and practiced with so little confidence. 

AND "ego psychology" 

I If space permitted, it would perhaps be profitable to 
ry to relate the foregoing discussion to that somewhat 
haotic but vigorously growing system of thought known 
Is contemporary learning theory. Starting as it did with 
list the two concepts of objectively observable stimula- 
ion and response, learning theory has gradually incorpo- 
ated certain subjective, or "intervening," variables, no- 
ably those of fear, relief, hope, and disappointment. Karl 
/[uenzinger, at the University of Colorado, has recently 
uggested a way in which "courage" can be operationally 
lefined and empirically studied in rats or other laboratory 

32 The Crisis in Psychiatry and Religion 

animals; and I think it entirely probable that learning 
theory will soon be elaborated to the point that it can 
be equally precise and explicit about the phenomenon of 
guilt. Already some progress has been made in this con- 
nection, but it would carry us too far afield to discuss this 
matter further [cf. Mowrer, 1960b; 1961]. 

Recently I was much interested and, I confess, not a 
little surprised to hear a physiological psychologist state 
that there is some evidence that the neurological cor- 
relates of the unconscious mind have now been at least 
roughly identified and that there is apparently here a 
capacity for gross emotional conditioning which may later 
affect the individual in ways very similar to those already 
attributed to conscience in this paper. Here, likewise, we 
will await further developments eagerly, with the pos- 
sibility in mind that we may, at long last, be approach- 
ing a way of thinking about psychopathology which 
articulates not only with social psychology and religion 
but also with learning theory and neurophysiology. 

But there is a more immediate consideration before 
us. A few months ago I heard a theologian say that al- 
though he was convinced that religion is relevant to the 
problem of mental health, he did not regard religion asi 
sufficient in this connection. When asked to elaborate,! 
the theologian said that he meant, quite simply, that reli- 
gion can deal with the conscious personality, but not 
with unconscious forces. This position reflects, of course, 
one way in which the church has tried to make peace 
with the ^secular healing professions; but there is a ques- 
tion as to whether such a ''division of labor" corresponds 
to reality. If the line of thought we have pursued in this 
paper is even remotely valid, religion, at its best, is always 
concerned with the unconscious, conceived as conscience 
and the Voice of God. The God of Moses was known as 
the Invisible God, and the church, quite generally, has 
been concerned with helping individuals live so that the} 
do not see God as an hallucination or hear his angr) 

Now if our general point of view here is tenable, one 
would have to entertain the same misgivings about th( 

° See Boisen's illuminating discussion (1952) of the "ex 
ternalization of conscience"; also Freud on the ''delusion o 
observation" (1933, p. 85). 

Changing Conceptions of the Unconscious 3B 

attempt which is commonly made to draw a Hne between 
psychological counseling and psychotherapy on the 
grounds that the latter deals with unconscious material 
whereas the former does not or at least should not. In 
November, 1950, the University of Minnesota was host 
to a conference on ''Concepts and Programs of Counsel- 
ing"; and at that time I gave a paper entitled "Anxiety 
Theory as a Basis for Distinguishing between Counseling 
land Psychotherapy." Much of what was said on that oc- 
jcasion is congruent with the present discussion. Take for 
;example this sentence: "It makes an enormous difference 
(practically whether we, as therapists, are afraid of anxiety 
|in our patients (or in ourselves) [as something malignant 
and destructive] or whether we see it as essentially a con- 
structive ally both to our therapeutic efforts and to the 
best trends and forces within the patient" (p. 26). 

But I also took the position that we should clearly 
distinguish between two forms of helping activity — call 
them what you will — the one of which involves dealing 
with essentially normal persons, i.e., persons whose con- 
flicts and difficulties are still fully conscious, and the other 
involving persons in whom dissociation and repression 
have already occurred and where there is therefore an 
unconscious to deal with. While such a distinction may 
btill have a limited justification, it would now seem that 
[the psychological counselor, at least in principle, is in 
piuch the same position as the religious counselor. If our 
easoning has been correct, the normal individual has 
ictually a "larger" unconscious than does a disturbed per- 
on; and support, direct admonition, and counsel may 
)e one of the best means, in the latter case, to get con- 
icience to relax and again become "unconscious." As al- 
■eady suggested, the best way for a child to get his parents 
'off his back," to use a common but graphic expression, 
s for him to redeem himself with respect to past mis- 
deeds and to regain their confidence and trust for the 
[uture. Likewise, surely, the best hope of the conscience- 
;tricken adult is to associate himself with other persons 
)r ideas which can encourage and guide him into paths 
)f conduct that will lead ultimately to the approval rather 
han condemnation of conscience. 

Today it is difficult to discern clearly what is happening 
n the field of psychoanalysis. In general, it is in a state 

34 The Crisis in Psychiatry and Religion 

of crisis and uncertainty [cf . Chapter 1 3] . But one trend 
stands out rather unmistakably, namely, the growing em- 
phasis upon *'ego psychology." I cannot claim to have 
been a close student of this trend, but even from afar 
one sees in it developments which are complementary to 
the thinking we are here exploring. Here, instead of stress- 
ing superego over-severity, we find more reference to the 
importance of ego adequacy. Here it is not nearly so much 
a question, as it was formerly, of how to pare down or 
reform the conscience; rather the question is, how to get 
the conscious self-system or ego of the individual to grow 
and mature, so that it is more responsible and more com- 
petent to deal with the manifold demands that impinge 
upon it. Here, surely, the work of the minister, the coun- 
selor, the teacher, and the parent are all highly pertinent; 
and where intensive, specialized psychotherapy becomes 
necessary, it is presumably not so much a question of 
reversing or undoing the work of others but instead a 
matter of trying to carry on where others have left off or 
have failed. 

On the whole, however, one has the impression that 
the development of ego psychology has not as yet pro- 
ceeded very far in psychoanalytic quarters. Certainly 
Federn's 1952 (posthumous) volume. Ego Psychology 
and the Psychoses, cannot be said to have shed any great 
new light upon these matters. This book is abstruse and 
still so heavily encumbered with classical psychoanalytic 
jargon that whatever innovations it contains are very hard 
to discover. Far more illuminating and, it would seem, 
more promising is the approach suggested by Shoben in 
his paper entitled, "Toward a Concept of the Normal 
Personality" (1957). Although he does not use the term, 
Shoben here is largely concerned with ego psychology. He 
says, unequivocally, that the normal, integrated, mature 
individual must of necessity be concerned with self-con- 
trol, honesty, personal responsibility, and compassion and 
affection for others and that how one conceptualizes life 
and interpersonal relationships is of the essence. "Ideolo- 
gies are at issue here," he frankly says and argues persua- 
sively for the importance also of values and value systems. 
Here, surely, is an ego psychology — and one with which 
the social scientist as well as the theologian can very 
largely agree [see also Waelder, I960]. 

Changing Conceptions of the Unconscious -^ 

Writing on the Oxford Group movement, in 1950, 
Walter H. Clark described the difference between the 
aims of psychoanalysis and religion thus: ''Both the psy- 
chiatrist and the Group want to reduce the sense of guilt 
— the former by reducing the aim, the latter by increas- 
ing the accomplishment" (p. 238). While there is no 
denying that we sometimes set for ourselves and for 
others unrealistic aims, yet it now appears that less harm 
is usually done on this score than when an attempt is 
made to be dehberately less, morally, than we potentially 
are. A scholarly friend tells me that our our word an- 
thopoid comes from a Greek word meaning, "with the 
head up." And we are apparently in the process of dis- 
covering that we cannot solve our problems by looking 
"down" without also losing perhaps the most distinctive 
aspect of our humanity. 



From the foregoing discussion it would seem that psy- 
chology and related disciplines are undergoing a period of 
painful reappraisal; and our vision and understanding 
are still far from perfect with respect to the end points of 
this movement and change. But perhaps the way is suffi- 
ciently illuminated for us to see before us a few steps 

Jourard says that in assuming that repression can be 
directed toward either id or superego, an impasse has 
been reached; and we have here tried to cut through that 
impasse by exploring the proposition that in psychopa- 
thology the trouble arises, not from what is being re- 
pressed, but rather from what, in the form of a wrathful 
conscience, is being expressed. Past disregard, denial, or 
'repression" of conscience may, to be sure, account for 
the present outbreak or "attack"; but the very presence of 
disturbance means that the repression has broken down. 
And the psychotherapeutic task, it would seem, is much 
less that of releasing the repressed than of helping the 
individual understand what is happening to him and 
how he can help make the final outcome constructive 
rather than destructive. 

However, our hypothesis does not at the same time ex- 

^^ ^^ The Crisis in Psychiatry and Religion 

elude the possibility of impulse repression, in at least a 
limited sense. For some time now I have been interested 
in collecting illustrations of seemingly bona fide impulse 
repression but which call for an interpretation rather dif- 
ferent from the one Freud proposed. From several pos- 
sible examples, allow me to select and present the fol- 
lowing one, because of its simplicity and brevity. It was 
reported to me by a colleague. He said (as I later recon- 
structed an informal conversation) : 

A week or so ago I had an experience which I think will 
interest you, as a psychologist. Some two months ago the 
chairman of the program committee of an organization to 
which I belong called and asked me to recommend someone 
as the speaker at the annual meeting of the organization. 
This I did, and I was pleased, when the occasion arrived, 
that the person whom I had suggested gave a quite excellent 
and well-received talk. Afterward, however, when my wife 
and I went home, I found I was vaguely dispirited; and, dur- 
ing the period of meditation which I practice before going to 
bed each night, I had a very peculiar experience. It was 
almost as if there was a "live coal" in a part of my mind, a 
sort of localized "anxiety" I suppose you'd call it. Then, all 
of a sudden, I realized that I had been jealous of the speaker; 
and immediately the "burning" sensation within me dissolved. 
I guess I knew I was now in a situation where I couldn't and 
wouldn't act upon my jealousy so it was safe for me to have 
the feeling. Needless to say, I was ashamed of myself for 
having had such a feeling. 

Here, apparently, was a situation where conscience, far 
from being repressed, had been instead the repressor. 
Like a parent who does not entirely "trust" a small child 
in some crucial social situation, conscience had held my 
friend, so to say, tightly *'in rein" and had released him 
only when the chance for misconduct had passed. There 
was, presumably, some history of past ungraciousness and 
envy in situations such as the one described; and it would 
only be with improved self-control and a genuine "change 
of heart" on the part of the individual in question that , 
his conscience could "trust" him to handle such a situa- 
tion responsibly and well. Here the goal of "therapy" 
would not be to release the repressed impulse but rather 
to help the individual grow in responsibility and "ego 

The term, ego strength, can of course be easily misun- 

Changing Conceptions of the Unconscious B7 

derstood. It can be taken to imply independence, self- 
sufEciency, and even selfishness and defiance. As we are 
presently conceiving of it, the term implies instead 
obedience and dedication to broad social objectives and 
values. Here the "strong" individual is not an individual 
who selfishly demands or refuses but one who instead 
serves and is loyal to a set of high social ideals and values. 
The point of view here expressed is, of course, mani- 
festly similar to that of religion. Our generation is one 
which has been said to have lost its "faith in God." Per- 
haps this loss of faith is related to a misconception of 
God, which the church itself, in recent centuries, has 
inadvertently fostered. God, we have been told, is some- 
thing out there: and we have forgotten that there is ex- 
cellent precedence for thinking of God also as some- 
thing in here, a part of our own selves and innermost ex- 
perience. For example, consider this passage from I 

And behold the Lord passed by, and a great and strong 
wind rent the mountains, and broke in pieces the rocks be- 
fore the Lord, but the Lord was not in the wind; and after 
the wind an earthquake, but the Lord was not in the earth- 
quake; and after the earthquake a fire, but the Lord was not 
in the fire; and after the fire — a still small voice {IS: 11-12). 

Can it be that we have lost faith in God because we 
have lost faith in conscience? Our widespread use of al- 
cohol and other so-called "tranquilizers" is surely, from 
one point of view, an expression of distrust of conscience; 
and in classical psychoanalysis, with its premise about the 
over-severity of the superego, the distrust is even more ex- 
plicit. There, as Boisen observes, the therapeutic aim is 
likened to that of surgery, with the superego the object of 
interest. We are now beginning to suspect that where 
psychoanalysis has been successful in its avowed aim, the 
result is likely to be, not a normal human being, but a 
person with manifest tendencies toward psychopathy and 
acting-out; but psychoanalysis is usually not so effective 
[cf . Chapter 1 3] . One of the cases cited by Stekel in his 
chapter on "diseases of conscience" has to do with a 
physician from India who had come to Vienna for treat- 
ment — and, also, it seems, because of Vienna's reputa- 
tion for liberality in the realm of sex. 

38 The Crisis in Psychiatry and Religion 

The patient sprang from a pious family [and] I pointed 
out that his troubles were due to a disease of conscience, and 
told him that the sleeplessness and pruritus would cease to 
trouble him if he refrained from the libertinage which was 
contrary to the principles in which he had been brought up. 
Realizing that I might be right, he broke off all his liaisons 
and returned to a fleshless diet. Thereupon the pruritus 
ceased, and he slept exceedingly well. . . . 

Psychologically interesting is the fact that [the physician 
was, however] extremely dissatisfied with the results of the 
treatment. He had expected the impossible. I ought to have 
freed him from his inward inhibitions, so that he could enjoy 
relations with as many women as he pleased (1938, pp. 322- 

Conscience would thus seem not readily altered, and 
perhaps we would do well to rethink and redirect our 
would-be therapeutic strategies. Certainly it is not easy 
to be a man as well as an animal, to be dominated by 
social as well as biological considerations. But the privilege 
of declining to at least make the supreme effort is ap- 
parently no longer ours. Man is that remarkable and 
paradoxical creature who has, as we may say, domesti- 
cated, socialized, and civilized himself, historically speak- 
ing; and this same drama, struggle, and high calling is one 
which is repeated, in miniature, in each of us. Therefore, 
the issues on which our personal success or failure, our 
humanity or inhumanity, our sanity or insanity hinges are 
as broad as the total human enterprise; and the preven- 
tion or correction of our human shortcomings can hardly 
be reduced to the level of the services performed by an 
automobile mechanic, the pharmacist on the corner, or 
even the surgeon — grateful as we are for their expert and 
specialized assistance on certain occasions. Surely with 
the slogan of the National Association for Mental Health, 
we can agree: "Mental health is everybody's business."" 
And any attempt, on the part of any professional or spe- 
cial-interest group to claim omnipotence and ''full re- 
sponsibility" in this field is as presumptuous as it is illogi- 

Is a society "sick" because it has standards, and rules^ 
and laws and punishes offenders thereof by fines, im- 
prisonment, or even death? Who would care to claim 
"full responsibility" in this area? The problem is neither 
larger nor smaller than our struggle to be fully human. 

Changing Conceptions of the Unconscious 39 

And is an individual "sick" because he, too, has standards 
and punishes himself, sometimes quite severely, for devia- 
tion therefrom? A penitentiary is the place we send those 
whom society condemns; and a mental hospital is the 
abode of the self-condemned — or, as Boisen has called it, 
a sort of this-worldly purgatory, from which a person may 
return, to a more abundant life, or in which he can also 
sink into the hell of a living death [see Chapter 3]. 

We thought it a great gain when, a century or so ago, 
we began to try to perceive the insane as sick rather than 
as sinful. But we are now wondering, to put it as a quip, 
if sin is not the lesser of two evils [cf . Chapter 4] . Citing 
the supporting views of Marzolf and Riese, Shoben says : 

Recently, there has been a considerable dissatisfaction with 
the whole notion of interpreting psychological states in 
terms of disease analogies. Maladjustive behavior patterns, the 
neuroses, and — perhaps to a lesser extent — the psychoses 
may possibly be better understood as disordered, ineffective, 
and defensive styles of life than as forms of sickness (1957, 
p. 184). 

One of the features of the Protestant Reformation that 
gave it such dynamic power and wide appeal was the doc- 
trine of "the priesthood of all believers" and belief in 
"the sanctity of the common life." Nothing, it would 
seem, short of a similarly broad and universal invitation 
and challenge, to each and every member of contem- 
porary society, can represent a fully rational and poten- 
tially more effective attack upon contemporary man's 
faltering faith and tottering reason. 

Some Constructive Features 
of the Concept of Sin* 

As long as one adheres to the theory that psychoneuro- j 
sis implies no moral responsibility y no error, no misdeed j 
on the part of the afflicted person, ones vocabulary can, ■ 
of course, remain beautifully objective and '' scientific ^ \ 
But as soon as there is so much as a hint of personal ac- \ 
countability in the situation, such language is, at the i 
very least, wide of the mark and, conceivably, quite mis- ] 
leading. Therefore, if ''moral judgment'' does enter the \ 
picture, one might as well beard the lion and use the \ 
strongest term of all, sin. This is the strategy involved in • 
the present and following chapter. 1 

But there is also a deeper objective here. ''Sickness/* as \ 
we shall see increasingly in later chapters, is a concept ] 
which generates pervasive pessimism and confusion in 
the domain of psychopathology; whereas sin, for all its 
harshness, carries an implication of promise and hope, a 
vision of new potentialities. Just so long as we deny the 
reality of sin, we cut ourselves off, it seems, from the 
possibility of radical redemption {"recovery*'). 

In some ways it is perhaps not surprising that we are ■ 
assembled here today to explore the question of whether ^ 
real guilt, or sin, is relevant to the problem of psychopa- 
thology and psychotherapy. For half a century now we I 
psychologists, as a profession, have very largely followed ^ 
the Freudian doctrine that human beings become emo- J 
tionally disturbed, not because of their having done any- 1 

* One of four papers comprising a symposium on "The Role | 
of the Concept of Sin in Psychotherapy" held at the 1959 | 
meeting of the American Psychological Association, in Cin- i 
cinnati, Ohio {American Psychologist, 1959, 14, 356) and later | 
published in the Journal of Counseling Psychology, 1960, 7, 
185-1 8 8. This paper has also appeared, without authorization, in 
Catholic Mind, 1960, S8, 151-155.) 


Constructive Features of Concept of Sin 41 

thing palpably wrong, but because they instead lack in- 
sight. Therefore, as would-be therapists we have set out 
to oppose the forces of repression and to work for under- 
standing. And what is this understanding, or insight, 
which we so highly prize? It is the discovery that the 
patient or client has been, in effect, too good; that he 
has within him impulses, especially those of lust and 
hostility, which he has been quite unnecessarily inhibit- 
ing. And health, we tell him, lies in the direction of 
recognizing and expressing these impulses. 

But there are now widespread and, indeed, ominous 
signs that this logic and the practical strategies it seems 
to demand are ill-founded. The situation is, in fact, so 
grave that, as our presence here today suggests, we are 
even willing to consider the possibility that misconduct 
may, after all, have something to do with the matter and 
that the doctrine of repression and insight are more mis- 
leading than helpful. 

However, as soon as we psychologists get into a dis- 
cussion of this problem, we find that our confusion is 
even more fundamental than might at first appear. We 
find that not only have we disavowed the connection 
between manifest misconduct and psychopathology; we 
have, also, very largely abandoned belief in right and 
wrong, virtue and sin, in general. 

On other occasions when I have seen this issue under 
debate and anyone has proposed that social deviousness 
is causal in psychopathology, there is always a chorus of 
voices who clamor that sin cannot be defined, that it is 
culturally relative, that it is an unscientific concept, that 
it is a superstition — and therefore not to be taken se- 
riously, either in psychopathology or in ordinary, every- 
day experience. And whenever an attempt is made to 
answer these objections, there are always further objec- 
tions — often in the form of reductions to absurdity — 
which involve naivity or sophistry that would ill-become 
a schoolboy. Historically, in both literate and non-literate 
societies, human beings are supposed to have reached the 
age of discretion by early adolescence; yet here we have 
the spectacle of grown men and women soberly insisting 
that, in effect, they cannot tell right from wrong — and 
that no one else can. 

Now I realize how futile it is to try to deal with this 

42 The Crisis in Psychiatry and Religion 

kind of attitude in a purely rational or logical way. The 
subversive doctrine that we can have the benefits of 
orderly social life without paying for it, through certain 
restraints and sacrifices, is too alluring to be counteracted 
by mere reason. The real answer, I believe, lies along 
different lines. The unassailable, brute fact is that per- 
sonality disorder is the most pervasive and baffling prob- 
lem of our time; and if it should turn out that persons 
so afflicted regularly display (or rather hide) a life of 
too little, rather than too much, moral restraint and self- 
discipline, the problem would take on an empirical 
urgency that would require no fine-spun argument. 

Sin used to be — and, in some quarters, still is — defined 
as whatever one does that puts him in danger of going to 
Hell. Here was an assumed cause-and-effect relationship 
that was completely metaphysical and empirically un- 
verifiable; and it is small wonder that it has fallen into 
disrepute as the scientific outlook and method have 
steadily gained in acceptance and manifest power. But 
there is a very tangible and very present Hell-on-this-earth 
which science has not yet helped us understand very 
well; and so I invite your attention to the neglected but 
very real possibility that it is this Hell — the Hell of 
neurosis and psychosis — to which sin and unexpiated 
guilt lead us and that it is this Hell that gives us one of 
the most, perhaps the most realistic and basic criteria for 
defining sin and guilt. If it proves empirically true that 
certain forms of conduct characteristically lead human 
beings into emotional instability, what better or firmer 
basis would one wish for labeling such conduct as destruc- 
tive, self-defeating, evil, sinful? ^ 

If the Freudian theory of personality disorder were 
valid, one would expect neurotic and psychotic individuals 
to have lead exemplary, yea saintly lives — to have been 

^ There is, admittedly, an element of circularity in the above 
argument. If it is maintained that mental illness is caused by 
unacknowledged and unexpiated sin, or real guilt, then it adds 
nothing to our knowledge to define sin as that which causes 
mental illness. In fact, there is a sense in which such a defini- 
tion is not only circular but misleading (see Chapter 13). Ob- 
viously, what is needed is an independent criterion for identify- 
ing sin or guilt — cf. Chapters 10-11 and Mowrer, 1961. 

Constructive Features of Concept of Sin 45 

just too good for this world. The fact is, of course, that 
such individuals typically exhibit lives that have been dis- 
orderly and dishonest in extreme degree. In fact, this is 
so regularly the case [see Chapters 8 and 13] that one 
cannot but wonder how so contrary a doctrine as that of 
Freud ever gained credence. Freud spurned The Wish 
and exalted Reality. What he regarded as Reality may 
yet prove to have been the biggest piece of wishfulness of 

Or, it may be asked, how is it if sin and psychic suffer- 
ing are correlated that not all who sin fall into neurosis 
or psychosis? Here the findings of the Kinsey studies are 
likely to be cited, showing that, for example, many per- 
sons have a history of sexual perversity who are later quite 
normal. In other words, the argument is that since sin 
and persistent suffering do not always go hand-in-hand, 
there is perhaps no relationship at all. The answer to 
this question is surely obvious. Some individuals, alas^ 
simply do not have enough character, or conscience, to 
be bothered by their sins. These are, of course, the 
world's psychopaths. Or an individual may have been 
caught in his sin and punished for it. Or it may have 
weighed so heavily on his conscience that he himself 
has confessed it and made appropriate expiation. Or^ 
quite conceivably, in some instances the individual, with- 
out either detection or confession, may have set upon a 
program of service and good works which has also brought 
him peace and redemption. In other words, there is, 
surely, no disposition on the part of anyone to hold that 
sin, as such, necessarily dooms a person to interminable 
suffering in the form of neurosis or psychosis. The pre- 
sumption is rather that sin has this effect only where it 
is acutely felt but not acknowledged and corrected. 

Also, it is sometimes contended that individuals who 
eventually come to the attention of psychotherapists have, 
to be sure, been guilty of major errors of conduct; but, 
it is held, the illness was present first and the misconduct 
|was really just an expression or symptom thereof. If this 
were true, where then would we draw the line? Is there 
no such thing as moral responsibility and social ac- 
countability at all? Is every mean or vicious thing that 
you or I, as ordinary individuals, do not sin but rather an 

44 The Crisis in Psychiatry and Religion 

expression of "illness"? Who would seriously hold that a 
society could long endure which consistently subscribed 
to this flaccid doctrine? 

Then there is, of course, the view that, in the final 
analysis, all psychopathology — or at least its profounder 
forms — have a constitutional or metabolic basis. One 
must, I believe, remain open-minded with respect to this 
possibility — indeed, perhaps even somewhat hopeful with 
respect to it; for how marvelous it would be if all the 
world's madness, stupidity, and meanness could be elimi- 
nated through biochemistry. But over the years we have 
seen one approach after another of this kind come into 
prominence, with much heralding as the long-awaited 
break-through on the problem of mental disease, only to 
fade out as manifestly not quite the panacea we had 
imagined it to be. Some of us may, at this point, even 
suspect that today the main incentive for keeping the 
biochemical hypothesis alive is not so much the support- 
ing empirical evidence, which is meager enough, but in- 
stead the fact that it at least obliquely justifies the 
premise that the whole field of mental disorder is the 
proper and exclusive domain of medicine. Also, and 
again somewhat obliquely, it excuses the clergy from 
facing squarely the responsibilities that would devolve 
among them if neurosis and psychosis should indeed 
turn out to be essentially moral disorders. 

The conception of personality disturbance which at- 
taches major etiological significance to moral and inter- 
personal considerations thus faces formidable resistance, 
from many sources; but programs of treatment and pre- 
vention which have been predicated on these other views 
have gotten us nowhere, and there is no clear reason to 
think they ever will. Therefore, in light of the total situa- 
tion, I see no alternative but to turn again to the old, 
painful, but also promising possibility that man is pre- 
eminently a social creature and that he lives or dies, 
psychologically and personally, as a function of the open- 
ness, community, relatedness, and integrity which by 
good action he attains and by evil action destroys. 

As long as we could believe that the psychoneurotic's 
basic problem was not evil but a kind of ignorance, it 
did not seem too formidable a task to give him the^ 
requisite enlightenment or insight. But mental hospital^ 

Constructive Features of Concept of Sin 45 

are now full of people who have had this kind of therapy, 
in one guise or another, and found it wanting; and if we 
are thus forced to reconsider the other alternative, the 
therapeutic or redemptive enterprise, however clear it 
may be in principle, is by no means simple in practice. If 
the problem is genuinely one of morality, rather than 
pseudo-morality, most of us in the secular healing profes- 
sions, of psychology, psychiatry, or social work, find our- 
selves reduced to the status of laymen, with no special 
itraining or competence for dealing with or even approach- 
ing the problem in these terms. We know something, of 
course, about procedures for getting disturbed persons to 
talk about themselves, free-associate, "confess"; but the 
Iwhole aim of this strategy has been insight, not redemp- 
tion and personal reformation. And clergymen themselves 
Eave so often been told, both by their own leaders and 
y members of the secular healing professions, that they 
must recognize their own "limitations" and know when 
to "refer" that they, too, lack the necessary confidence 
and resources for dealing with these problems ade- 
quately [cf. Chapters 11, 12]. 

Many present-day psychoanalysts will offer no serious 
objection to the way in which classical Freudian theory 
and practice have been evaluated in this paper; but they 
will insist that many "advances" have been made since 
Freud's time and that these put the whole problem in a 
very different light. If we ask, "Precisely what are these 
advances?" we are told that they have to do with the 
pew emphasis upon "ego psychology" rather than upon 
I'the unconscious." But what did Emalian Gutheil 
(1958) tell us at our convention last year in Washington 
ibout ego psychology? He said that although analysts 
low recognize the ego as much more important than 
"ormerly, they know next to nothing about the conditions 
"or modifying or strengthening it; and the same position 
las been voiced earlier by Lawrence Kubie (1956) and 
in one of his very last papers (1937) even by Freud him- 
jelf [see also Chapter 13]. 

' Therefore, I do not see how we can avoid the conclu- 
sion that at this juncture we are in a real crisis with 
respect to the whole psychotherapeutic enterprise. But I 
do not think we are going to remain in this crisis, con- 
"used and impotent, indefinitely. There is, I believe, grow- 

46 The Crisis in Psychiatry and Religion 

ing realism with regard to the situation on the part of 
both psychologists and psychiatrists, on the one hand, 
and ministers, rabbis, and priests, on the other; and I am 
hopeful and even confident that new and better ways of 
dealing with the situation are in the making. 

What, precisely, these ways will be I do not know; but : 
I venture the impression that Alcoholics Anonymous; 
provides our best present intimation of things to come: 
and that the therapeutic programs of the future, whethen 
under religious or secular auspices, will, like AA, take: 
guilt, confession, and expiation seriously and will involve: 
programs of action rather than mere groping for "in- 
sight" [cf. Chapters 8 and 12]. 


*'Sin," the Lesser of Two Evils* 

When the paper which constitutes the preceding chap- 
ter was delivered at the symposium for which it was pre- 
pared, it created something of a ''sensation^ There was 
considerable stir over it at the convention itself; and 
stories appeared widely in newspapers and national maga- 
zines, including Time [Sept. 14, 1959 — *'The idea of sin, 
at least for use in treating the sick psyche, is making a 
comeback/' p. 69), Newsweek {Sept. 14, 1959, p. 108), 
and America {Sept. 12, 1960, pp. 686-687). 

Because the symposium paper was, of necessity, brief 
and left many facets of a complex problem unexplored, 
it seemed desirable to write a supplementary paper, 
which is reproduced herewith. In it a number of con- 
siderations are touched upon which open the way for 
more systematic discussion in subsequent chapters. 

Following the presentation of a paper on ''Construc- 
tive Aspects of the Concept of Sin in Psychotherapy" at 
the 1959 APA convention in Cincinnati, I have re- 
peatedly been asked by psychologists and psychiatrists : 
"But why must you use that awful word 'sin,' instead of 
some more neutral term such as 'wrongdoing,' 'irre- 
sponsibility,' or 'immorality'?" And even a religious lay- 
man has reproached me on the grounds that "Sin is such 
a strong word." Its strength, surely, is an asset, not a 
Hability; for in the face of failure which has resulted from 
our erstwhile use of feebler concepts, we have very heavy 
work for it to do. Besides, sin (in contrast to its more 
neutral equivalents) is such a handy little word that it 
would be a pity to let it entirely disappear from usage. 
With Humpty-Dumpty, we ought to expect words to be 
"well-behaved" and to mean what we want them to! 

* Read at a luncheon meeting of The University Religious 
Council, Ohio State University, Columbus, March 11, 1959, 
and published in The American Psychologist, 1960, 15, 301- 

i 47 

48 The Crisis in Psychiatry and Religioi 

A few years ago I was invited to teach in the summ( 
session at one of our great Pacific Coast universities; anc 
toward the end of the term, a student in my class on 
Personahty Theory said to me one day: ''Did you know 
that near the beginning of this course you created a kind 
of scandal on this campus?" Then he explained that I 
had once used the word "sin" without saying "so-called" 
or making a joke about it. This, the student said, was 
virtually unheard-of in a psychology professor and had 
occasioned considerable dismay and perplexity. I did not 
even recall the incident; but the more I have thought 
about the reaction it produced, the more frequently I 
have found myself using the term — with, I hope, some- 
thing more than mere perversity. 

Traditionally, sin has been thought of as whatever 
causes one to go to Hell; and since Hell, as a place of 
otherworldly retribution and torment, has conveniently 
dropped out of most religious as well as secular thought, 
the concept of sin might indeed seem antiquated and 
absurd. But, as I observed in the Cincinnati paper. Hell 
is still very much with us in those states of mind and 
being which we call neurosis and psychosis; and I have 
come increasingly, at least in my own mind, to identify 
anything that carries us toward these forms of perdition 
as sin. Irresponsibility, wrongdoing, immorality, sin:^ 
what do the terms matter if we can thus understand 
more accurately the nature of psychopathology and gain 
greater practical control over its ramified forms and 

But now the fat is in the fire! Have we not been 
taught on high authority that personality disorder is not 
one's own "fault," that the neurotic is not "responsible" 
for his suffering, that he has done nothing wrong, com- 
mitted no "sin"? "Mental illness," according to a poster 
which was widely circulated a few years ago, "is no dis- 
grace. It might happen to anyone." And behind all this, 
of course, was the Freudian hypothesis that neurosis stems 
from a "too severe superego," which is the product of a 
too strenuous socialization of the individual at the hands 
of harsh, unloving parents and an irrational society. The^ 
trouble lay, supposedly, not in anything wrong or "sinful" 
which the individual has himself done, but in things he 
merely wants to do but cannot, because of repression. 

"Sin," the Lesser of Two Evils 49 

The neurotic was thus not sinful but sick, the helpless, 
innocent victim of "the sins of the fathers," and could 
be rescued only by a specialized, esoteric form of treat- 
ment. Anna Russell catches the spirit of this doctrine well 
when she sings, in 'Tsychiatric Folksong," 

At three I had a feeling of 

Ambivalence toward my brothers, 
And so it follows naturally 

I poisoned all my lovers. 
But now I'm happy; I have learned 

The lesson this has taught; 
That everything I do that's wrong 

Is someone else's fault. 

Freud saw all this not only as a great scientific dis- 
covery but also as a strategic gain for the profession 
which had thus far treated him so indifferently. It was 
one may conjecture, a sort of gift, an offering or service 
which would place medicine in^^ueh debt to him that 
it could no longer ignore or reject him. In his Auto- 
TwgraphyTimd { 193 5 ) puts it thus: 

My medical conscience felt pleased at my having arrived 
at this conclusion [that neurosis has a sexual basis]. I hoped 
that I had filled up a gap in medical science, which, in deal- 
ing with a function of such great biological importance, had 
failed to take into account any injuries beyond those caused 
by infection or by gross anatomical lesions. The medical 
aspect of the matter was, moreover, supported by the fact that 
sexuality was not something purely mental. It had a somatic 
side as well . . . (p. 45). 

In his book on The Problem of Lay Analysis^ Freud 
(1927) later took a somewhat different position (see also 
Chapter 9 of the third volume of Jones' biography of 
Freud, 1957); but by this time his Big Idea had been let 
loose in the world and was no longer entirely under his 

Psychologists were, as we know, among the first of 
the outlying professional groups to "take up" psycho- 
analysis. By being analyzed, we not only learned — in an 
intimate, personal way — about this new and revolutionary 
science; we also (or so we imagined) were qualifying 
ourselves for the practice of analysis as a form of therapy. 

50 The Crisis in Psychiatry and Religion 

Now we are beginning to see how illusory this all was. 
We accepted psychoanalytic theory long before it had 
been adequately tested and thus embraced as ''science" 
a set of presuppositions which we are now painfully hav- 
ing to repudiate. But, more than this, in accepting the 
premise that the neurotically disturbed person is basically 
sick, we surrendered our professional independence and 
authenticity. Now, to the extent that we have subscribed 
to the doctrine of mental illness (and tried to take part 
in its "treatment"), we have laid ourselves open to some 
really very embarrassing charges from our friends in psy- 

In 1954 the American Psychiatric Association, with 
the approval of the American Medical Association and 
the American Psychoanalytic Association, published a 
resolution on "relations between medicine and psy- 
chology," which it re-issued (during the supposed "mor- 
atorium") in 1957. This document needs no exten- 
sive review in these pages; but a few sentences may be 
quoted to indicate what a powerful fulcrum the sickness 
conception of neurosis provides for the aggrandizement 
of medicine. 

For centuries the Western world has placed on the medi- 
cal profession responsibility for the diagnosis and treatment 
of illness. Medical practice acts have been designed to protect 
the public from unqualified practitioners and to define the 
special responsibilities assumed by those who practice the 
healing art. . . . Psychiatry is the medical speciality con- 
cerned with illness that has chiefly mental symptoms. . . . 
Psychotherapy is a form of medical treatment and does not 
form the basis for a separate profession. . . . When mem- 
bers of these [other] professions contribute to the diagnosis 
and treatment of illness, their professional contributions must 
be coordinated under medical responsibility (pp. 1-2). 

So long as we subscribe to the view that neurosis is a i 
bona fide "illness," without moral implications or dimen- 
sions, our position will, of necessity, continue to be an 
awkward one. And it is here I suggest that, as between 
the concept of sin (however unsatisfactory it may in 
some ways be) and that of sickness, sin is indeed the 
lesser of two evils. We have tried the sickness horn of 
this dilemma and impaled ourselves upon it. Perhaps, 

"Sin," the Lesser of Two Evils 51 

despite our erstwhile protestations, we shall yet find sin 
more congenial. 

We psychologists do not, I believe, object in principle 
to the type of authority which psychiatrists wish to exer- 
cise, or to our being subject to other medical controls, 
if they were truly functional. But authority and power 
ought to go with demonstrated competence, which medi- 
cine clearly has in the physical realm but, equally clearly, 
jdoes not have in "'psychiatry." Despite some pretentious 
affirmations to the contrary, the fact is that psycho- 
;analysis, on which modern "dynamic" psychiatry is largely 
ibased, is in a state of virtual collapse and imminent 
idemise. And the tranquilizers and other forms of so- 
called chemotherapy are admittedly only ameliorative, 
not basically curative. So now, to the extent that we 
have accepted the "illness" postulate and thus been 
lured under the penumbra of medicine, we are in the 
ungraceful maneuver of "getting out." ^ 

But the question remains: Where do we go, what do 
we do, now? Some believe that our best policy is to 
become frankly agnostic for the time being, to admit 
that we know next to nothing about either the cause or 
correction of psychopathology and therefore ought to 
concentrate on research. This is certainly a safe policy, 
and it may also be the wisest one. But since this matter 
of man's total adjustment and psychosocial survival does 
not quickly yield up its innermost secrets to conventional 
types of scientific inquiry, I believe it will do no harm 
for us at the same time to be thinking about some 
frankly ideological matters. 

^Thoughtful psychiatrists are also beginning to question the 
legitimacy of the disease concept in this area. In an article en- 
titled 'The Myth of Mental Illness" which appeared after this 
paper went to press, Thomas S. Szasz (1960) is particularly 
outspoken on this score. He says: ". . . the notion of mental 
illness has outlived whatever usefulness it might have had and 
. . . now functions merely as a convenient myth. . . . mental 
illness is a myth, whose function it is to disguise and thus 
render more palatable the bitter pill of moral conflicts in hu- 
man relations" (p. 118). Szasz entire article deserves careful 

52 The Crisis in Psychiatry and Religion 

For several decades we psychologists looked upon the 
whole matter of sin and moral accountability as a great 
incubus and acclaimed our liberation from it as epoch- 
making. But at length we have discovered that to be 
"free" in this sense, i.e., to have the excuse of being 
"sick" rather than sinful, is to court the danger of also 
becoming lost. This danger is, I believe, betokened by 
the widespread interest in Existentialism which we are 
presently witnessing. In becoming amoral, ethically neu- 
tral, and "free," we have cut the very roots of our being; 
lost our deepest sense of self-hood and identity; and, 
with neurotics themselves, find ourselves asking: Who 
am I? What is my destiny? What does living (existence) 

In reaction to the state of near-limbo into which we 
have drifted, we have become suddenly aware, once 
again, of the problem of values and of their centrality 
in the human enterprise. This trend is clearly apparent 
in the programs at our recent professional meetings, in 
journal articles, and, to some extent already, in our 
elementary textbooks. Something very basic is obviously 
happening to psychologists and their "self-image." 

In this process of moving away from our erstwhile 
medical "entanglements," it would be a very natural 
thing for us to form a closer and friendlier relationship 
than we have previously had with religion and theology. 
And something of this sort is unquestionably occurring. 
At the APA Annual Convention in 1956 there was, for 
the first time in our history I believe, a symposium on 
religion and mental health; and each ensuing year has; 
seen other clear indications of a developing rapproche-; 
ment. | 

However, here too there is a difficulty — of a most 
surprising kind. At the very time that psychologists are 
becoming distrustful of the sickness approach to person- 
ality disturbance and are beginning to look with more 
benign interest and respect toward certain moral and 
religious precepts, religionists themselves are being caught 
up in and bedazzled by the same preposterous system of 
thought as that from which we psychologists are just 
recovering. It would be possible to document this develop- 
ment at length; but reference to such recent "theological" 
works as Richard V. McCann's Delinquency — Sicknesi 

'Sin," the Lesser of Two Evils 53 

or Sin? (1957) and Carl Michalson's Faith for Personal 
Crises (1959, see especially Chapter 3) will suffice. 

We have alluded to Anna Russell's ''Psychiatric Folk- 
song" and, in addition, should call attention to Katie 
Lee's 12-inch LP recording "Songs of Couch and Con- 
sultation." That entertainment and literary people are 
broadly rejecting psychoanalytic froth for the more solid 
substance of moral accountability is indicated by many 
current novels and plays. It is not without significance 
that Arthur Miller's Death of a Salesman, written in the 
philosophical vein of Hawthorne's great novel The 
pcarlet Letter, has, for example, been received so well. 

How very strange and inverted our present situation 
therefore is! Traditionally clergymen have worried about 
the world's entertainments and entertainers and, for a 
time at least, about psychology and psychologists. Now, 
ironically, the entertainers and psychologists are worrying 
about the clergymen. Eventually, of course, clergymen 
will return to a sounder, less fantastic position; but in 
the nieantime, we psychologists can perhaps play a socially 
useful and, also, scientifically productive role if we pursue, 
ivith all seriousness and candor, our discovery of the 
essentially moral nature of human existence and of that 
'living death" which we call psychopathology. This, of 
course, is not the place to go deeply into the substantive 
aspects of the problem; but one illustration of the fruit- 
ulness of such exploration may be cited. 

In reconsidering the possibility that sin must, after 
ill, be taken seriously, many psychologists seem per- 
plexed as to what attitude one should take toward the 
nnner. "Nonjudgmental," "nonpunitive," "nondirective," 
warm," "accepting," "ethically neutral": these words 
liave been so very generally used to form the supposedly 
Droper therapeutic imago that reintroduction of the 
oncept of sin throws us badly off balance. Our attitudes, 
is would-be therapists or helping persons, toward the 
aeurotic (sinner) are apparently less important than his 
ittitude toward himself; and, as we know, it is usually — 
in the most general sense — a rejecting one. Therefore, 
we have reasoned, the way to get the neurotic to accept 
md love himself is for us to love and accept him, an 
nference which flows equally from the Freudian assump- 

54 The Crisis in Psychiatry and Religion 

tion that the patient is not really guilty or sinful but 
only fancies himself so and from the view of Rogers 
that we are all inherently good and are corrupted by our 
experiences with the external, everyday world. 

But what is here generally overlooked, it seems, is 
that recovery (constructive change, redemption) is most 
assuredly attained, not by helping a person reject and 
rise above his sins, but by helping him accept them. 
This is the paradox which we have not at all understood 
and which is the very crux of the problem. Just so long 
as a person lives under the shadow of real, unacknowl- 
edged, and unexpiated guilt, he cannot (if he has any 
character at all) ''accept himself"; and all our efforts to 
reassure and accept him will avail nothing. He willi 
continue to hate himself and to suffer the inevitable 
consequences of self-hatred. But the moment he (with 
or without "assistance") begins to accept his guilt and! 
his sinfulness, the possibility of radical reformation opens 
up; and with this, the individual may legitimately, though 
not without pain and effort, pass from deep, pervasive 
self-rejection and self-torture to a new freedom, of self- 
respect and peace. 

Thus we arrive, not only at a new (really very old) | 
conception of the nature of ''neurosis" which may change j 
our entire approach to this problem, but also at an 
understanding of one of the most fundamental fallacies 
of Freudian psychoanalysis and many kindred efforts at. 
psychotherapy. Freud observed, quite accurately, that the 
neurotic tortures himself; and he conjectured that this 
type of suffering arose from the irrationality and over- 
severity of the superego. But at once there was an em- 
pirical as well as logical difficulty which Freud (unlike 
some of his followers) faithfully acknowledged. In the 
New Introductory Lectures on Psychoanalysis (1933), 
he said: 

The supergo [paradoxically] seems to have made a one- 
sided selection [as between the loving and the punitive atti- 
tudes of the parents], and to have chosen only the harshness, 
and severity of the parents, their preventive and punitive 
functions, while their loving care is not taken up and con- 
tinued by it. If the parents have really ruled with a rod of 
iron, we easily understand the child developing a severe su- 
perego, but, contrary to our expectations, experience shows 

Sin," the Lesser of Two Evils 55 

that the supergo may reflect the same relentless harshness 
even when the up-bringing has been gentle and kind (p. 90). 

And then Freud adds, candidly: *'We ourselves do not 

feel that we have fully understood it." In this we can 

illy agree. For the only way to resolve the paradox of 

If-hatred and self-punishment is to assume, not that 

represents merely an "introjection" of the attitudes of 

thers, but that the self-hatred is realistically justified and 

ill persist until the individual, by radically altered atti- 

de and action^ honestly and realistically comes to feel 

at he now deserves something better. As long as one 

mains, in old-fashioned religious phraseology, hard-of- 

eart and unrepentant, just so long will one's conscience 

old him in the vise-like grip of "neurotic" rigidity and 

offering. But if, at length, an individual confesses his 

ast stupidities and errors and makes what poor attempts 

le can at restitution, then the superego (like the parents 

an earlier day — and society in general) forgives and 
laxes its stern hold; and the individual once again is 
ee, "well" [cf. Chapter 2]. 

But here we too, like Freud, encounter a difficulty, 
here is some evidence that human beings do not change 
idically unless they first acknowledge their sins; but we 
so know how hard it is for one to make such an 
knowledgment unless he has already changed. In other 
ords, the full realization of deep worthlessness is a 
vere ego "insult"; and one must have some new source 

strength, it seems, to endure it. This is a mystery (or 

it only a mistaken observation?) which traditional 
leology has tried to resolve in various ways — v/ithout 
)mplete success. Can we psychologists do better? 


Judgment and Suflfering: 
Contrasting Views* 

It has been argued that if real rather than false (Freud- 
ian) guilt is at the root of neurosis and functional 
psychosis, then therapy should, logically, take the form 
of ''punishment'' rather than ''treatment^ Yet the elim- 
ination of punishment ["mistreatment'') of the insane 
has been regarded as a great cultural and humane achieve- 
ment of the last century or two. Here, obviously, is c 
complicated issue, which has already been alluded to neat 
the end of the preceding chapter. While it is not certair, 
j that punishment from without {e.g., the use of electro- 
j convulsive shock) has no legitimate place in a restorative 
\ program, the fact is that the distinguishing feature O] 
most forms of psychopathology is that the individua 
is punishing himself — or at least trying to. The questior 
is. How should we interpret this tendency, as "crazy'] 
or potentially curative? Other aspects of this intricaU 
but important problem will be considered, from timi 
to time, in later chapters. 

In May, 1959, it was my good fortune to participate 
in a week-long institute held at the University of Sas 
katchewan under the auspices of the Provincial Govern 
ment, primarily for psychologists; but there were alsc 
three psychiatrists and a clergyman in the group, so tha 
our discussions had a distinctly interdisciplinary flavor 
And from these discussions emerged what was for me 5 
new insight concerning contemporary attitudes towarc 
suffering which I believe deserves wider consideration 

During the course of the lectures which it was m; 
privilege to give, I reiterated a point of view concerninj 
the origin and meaning of psychopathology which ha 
been taking shape in my mind over the course of th< 
past 12 or 15 years. Guilt, I argued, is the central prob 
lem — not just guilt feelings, as Freud so beguilingl; 

* Initially published in Faculty Forum, October, 1959, pp 



iggested, but real, palpable, indisputable guilt; and 
ere I was at pains to review clinical evidence that dis- 
irbed persons are not ^'disturbed" for nothing. Where 
eurosis or psychosis is purely functional (as it usually 
) , the individual, I believe, always has a hidden history 
E serious misconduct which has not been adequately 
Dmpensated and ''redeemed." And if this be so, then 
Dnfession, expiation, and ''a new life in Christ" (or 
)me equivalent type of conversion) have a practical 
ertinence which far exceeds the boundaries behind 
hich some theologians have attempted to hold them. 
There was, I may say, an immediately positive response 
) this point of view on the part of many members of 
le group, including one of the psychiatrists and several 
f the psychologists. But there was also manifest reserva- 
on and resistance on the part of others; so we took 
)me time to hear these persons out and try to under- 
:and their misgivings. 

; Presently it emerged that several of the members of 

[ir group felt that this point of view was ''punitive" 

jid "rejecting" and "countertherapeutic"; for how could 

ae accept it, they asked, without blaming the patient 

id being disposed to punish him? These avowals brought 

;veral important issues out into the open. First of all, 

ley permitted other members of the group to point out 

lat no one else needs to blame or punish the mental 

ifferer: he is blaming and punishing himself (or at least 

ying to) — this is the very essence of his condition. 

herefore, we can and should show him all the love and 

larity within our souls, and do not need in the least to 

ay a punitive role. But this is very different from saying 

lat we should dispute or brush aside his assertions of 

lilt or minimize the reality of his need for deliverance. 

veral members of the group expressed the conviction 

at much of our present would-be therapeutic effort 

useless and even harmful because we so actively oppose 

e patient's own most substantial psychological realities 

d his brightest prospects for change and recovery, i.e., 

5 conviction of guilt and sense of sin. Perhaps the 

tient is not so wrong, not so "crazy" as some of our 

m theories have been! 

Then our discussion took a historical turn, and we 
:gan to see how widespread and pervasive has been, in 

58 The Crisis in Psychiatry and Religio 

recent times, the belief that suffering is never "de- 
served/' never creative and reconstructive. It can hardl) 
be doubted that in many primitive societies the notion 
of accountabihty is overworked; and one can point tc 
clear examples of the same sort of thing in the history 
of Western civilization. For example, not so long ago we 
held that physical illness and accidents were **God's 
judgment" rather than the wholly impersonal conse- 
quences of germs or other circumstances beyond the 
individual's control; and we also were inclined, until 
fairly recently, to suppose that all poverty must reflect 
sloth or other sins, rather than recognize social injustice 
and economic exploitation. 

But now, in our reaction against this patent overexten- 
sion of ''moral" principle, have we not gone too far iii 
the other direction? There is, as we know, a widespreac 
tendency — sometimes called "scientism" — to assume thai 
human beings cannot be ''responsible" for anything, thai 
we are all just cogs in a vast cause-and-effect comple? 
and are in no way accountable for anything we do oi 
anything that happens to us. Such a doctrine, aside fron 
its lack of genuine scientific justification, is devastating 
no society could long endure which thoroughly acceptec 
it — and neither can an individual human being [cf 
Mowrer, 1961]. 

As we look around us, at mid-twentieth century, tw( 
of the most distressing "symptoms" of our times are (a) 
confusion and apathy in the matter of moral value 
(witness the "beatnik" movement) and (b) an apparen 
paralysis with respect to the spectre of mental illness 
Can it be that the two conditions are related and tha 
they exist in such acute form precisely because we havt 
insisted upon separating them? Perhaps mental dis-easi 
has a meaning and a potential which we fail to recognize 

The whole thrust of medicine is, of course, in th( 
direction of the "alleviation of suffering"; and we an 
deeply grateful for most medical efforts and accomplish 
ments. But when medicine extends this principle ove 
into the moral realm, as it ostensibly does in its attemp 
to treat personality disorders, the results are far fron 
reassuring. Psychoanalysis promised to deliver us frori 
neurotic suffering by the bold expedient of reducing th 
"severity" of our consciences. Unable to make good thi 


iromise, analysis is on the wane; and psychiatry is now 

aptivated by the chemical "tranquilizers." Pick up an 

5sue of the American Journal of Psychiatry (as I recently 

lid) and what do you find? Nine of the ten full-page 

T two-page advertisements in the front of the journal 

sading as follows: "control of emotional turbulence 

-luminal/' "peace of mind — atarax," "calmness, co- 

perativeness — serpasil," "relief of anxiety — compazine," 

valuable in all degrees of psychic disorder — trilafon," 

intravenous anesthetic — pentothal," "relieves tension — 

quanil," "normalizes thinking — pacatal," "produces re- 

ixation — sandril." The other ad was for a portable tape 

ecorder! Combine with this the fact that such a large 

ercentage of other forms of advertising are for those 

e-old "tranquilizers," alcohol and tobacco, and one 

es that the diagnosis of our time as the "Aspirin Age" 

a magnificent understatement. What would happen 

modern man were forced to confront his guilt and 

security for just one week without these masks and 

dutches? Would it destroy us completely or perhaps 

pint the way to a saner and better life? 

Historically, the church has been dedicated not to 

mfort but to change, redemption, rebirth. Ultimately 

s objective, no less than that of medicine, was to relieve 

ffering — ^yea, more, to bring salvation and joy. But it 

d not flinch from holding that sometimes suffering is 

e absolute and inescapable precondition for our trans- 

)rmation and redemption. What of the modern church? 

s child-rearing became permissive, religion also became 

ion judgmental" and obligingly eliminated Hell. God 

now love and love alone, and judgment is old-fash- 

med. This past week a student put into my hands a 

eekly bulletin from one of our local Protestant churches 

hich proclaims that God is "a generous, loving Father" 

pose "favor toward man is freely given" and takes the 

Oman Catholics to task for "emphasizing that God is 

pod of justice"! 

Old Testament writers knew that God and parents 
id conscience can be justifiably angry and that we 
nore them at our peril. In denying the moral implica- 
Dns of suffering and seeking to cushion ourselves against 
do we not misperceive and mismanage it in wa.yr 
hich, in the long run, can only spell disaster? 

The New Challenge to our Qiurches 
and Seminaries: 

I. A Question of Theory* j 

In the preceding chapters, attention has been mainlj 
directed to the "crisis'* in psychiatry and clinical psy 
chology which has been occasioned by the pervasiv^ 
acceptance of Freudian psychoanalysis, with its basically 
biological orientation and emphasis. In this chapter am 
the immediately succeeding ones, we now look, mon 
explicitly, at the predicament of the churches and semi 
naries. At prst slow to accept Freudianism, they are todo) 
displaying an astonishing reluctance to let go of it. Tni 
chapter gives some little-known facts about the histor} 
of the pastoral counseling movement and shows how 
after a promising start in the right direction, it was de 
fleeted and distorted by psychoanalytic theory and non 
directive counseling techniques. 

Initially written, by invitation, for a well known re 
ligious periodical, this paper {and its sequel, see Chaptei 
7) was formally accepted and then mysteriously rejected 
Did the latter action reflect defensiveness and reluctanci 
to face up to some unpleasant facts? Or is there some 
thing basically inaccurate or perhaps unfair in the presem 
analysis? | 

Has evangelical religion sold its birthright for a mes! 
of psychological pottage? In attempting to rectify theii 
disastrous early neglect of psychopathology, have th< 
churches and seminaries assimilated a viewpoint anc 
value system more destructive and deadly than the evi 
they were attempting to eliminate? As a psychologist 
and churchman, I believe the answer to these question; 
is in the afErmative. If so, the time is upon us for i 
searching reappraisal and a new plan of action. 

But first let me correct a possible misapprehension 

* Published in Foundations: A Baptist Journal of Histor) 
and Theology, October, 1960, 3, 335-347. 



lere are, I know, some ministers and seminary profes- 
:s who would be only too happy to have done with 
s whole "clinical movement." I mean to give them no 
mfort; for I agree completely with Harry Emerson 
isdick when he says (in a recent article) that earlier in 
is century there was in Protestant theology and pastoral 
ictice a gaping "vacancy" here which urgently needed 
be "filled." The issue I wish to discuss is not the 
acancy" — that has been only too painfully real — ^but 
e question of whether the way in which it has been 
d is being filled is sound. I do not ask for less religious 
ncem and effort for troubled persons but for more, of a 
ierent and, hopefully, better kind. 


In January of 1926, a then little-known man by the 
me of Anton T. Boisen published in Christian Work 
. article which has drastically modified theological edu- 
pon and changed church history. It was entitled "The 
[lallenge to Our Seminaries," and its salient thesis was 
at "in mental disorders we are dealing with a problem 
liich is essentially spiritual" (p. 8). Said Boisen: 

But of any such possibilities the Church is utterly ob- 
ivious. She takes no interest in cases of pronounced mental 
iisorder. . . . We have therefore this truly remarkable situa- 
tion — a Church which has always been interested in the 
pare of the sick, confining her efforts to the types of cases 
physical illness] in which religion has least concern and 
east to contribute, while in those types in which it is impos- 
;ible to tell where the domain of the medical worker leaves 
iff and that of the religious worker begins, there the Church 
s doing nothing (p. 9). 

Since Fundamentalism preached only a hell to come 
d liberal theology preached no hell at all, both, argued 
tisen, were "blind to the hell which is right before our 


When we remember that what we know today about the 
luman body has come very largely through the study of dis- 
:ase conditions, is it any wonder that a Church which has 
completely ignored the problem of the soul that is sick, 
s able to speak with so little authority concerning the laws 
)f the spiritual world? (p. 10). 

62 The Crisis in Psychiatry and Religic 

Boisen's plea, therefore, was that the seminaries sts; 
sending their students to mental hospitals for an "i 
ternship" of a few months or a year. 

For we have here a problem which must be studied frc 
real life and not from books. It is, moreover, absolutely 
sential to have the co-operation of medical men, for hci 
the provinces of religious and medical workers overlap, a; 
the medical worker is now in possession of the field. T] 
religious worker is a mere beginner, and he must be v(J 
careful not to embark on any half-attempt at "soul-healini 

(p. 11). I 

In this way the young minister, upon leaving t 
seminary, would be able to bring "a new religious p:^ 
chology" to the people, so that "the Church may od 
more come into its own and speak no longer as t' 
scribes and Pharisees and interpreters of traditions l 
with the authority of the knowledge of the laws of t 
life that is eternal" (p. 12). 


The impact of this article and others of a simi 
nature was such that young theologians soon began goi 
to mental hospitals for the type of internship which I 
Boisen recommended; and by 1930 the ''clinical mo 
ment" had gained sufficient momentum to warrant 1 
formation of The Council for Clinical Pastoral Traini: 
to be followed in 1944 by another organization cal 
The Institute for Pastoral Care. Niebuhr, Williams, a 
Gustafson, in their 1957 book on The Advancement 
Theological Education, comment upon these deveL 
ments as follows: 

These two programs have between them initiated i 
been responsible for a considerable part of the clinical tr; 
ing of pastors for twenty -five years. Many schools have m 
use of these programs or devised similar ones (p. 123). 

The growth of this program is shown by the follow 
data. In 1943 thirteen seminaries were related to some k 
of clinical training program. Nine years later in 1952 tt 
were forty- three schools. Reports made to the present st 
indicate that about three-fourths of the accredited seminai 
one- third of others, had either developed clinical trair 
programs of their own by 1955 or sent students to 
Council or Institute for such training (p. 124). 


. . . the close connection between the traditional disci- 
pline of "pastoral theology" or "care of soul" and the psy- 
chological approach to human personality through first-hand 
experience of human problems is widely recognized today, 
and has given rise to one of the most influential movements 
[in theological education, the emphasis on the preparation of 
the Christian pastor as counselor (p. 122). 

There is, of course, no need to document extensively 
e contrast between the situation in 1926 and now as 
r as the resurgence of religious interest in personality 
sturbance is concerned; it is immediately apparent to 
yone who has been a church member during this 
riod, and only a little less so to others. However, there 
p signs of acute unrest and tension in this area, both 

the churches and the seminaries; and it will be our 
ijective in the remainder of this article to expose the 
eoretical issues here involved and, in the sequel to 
is discussion, to suggest a different practical approach 

the whole problem. 


Not only did Anton Boisen, in his early articles, show 
e urgency of renewed religious interest in the mentally 
; he also, in 1936, published a highly readable and 
rceptive book, The Exploration of the Inner World, 

which he outlined the theory of psychopathology 
lich he believed most congruent with the great insights 

religion and most likely to lead to more effective 
evention and treatment. Elsewhere [see Chapter 2] 
lave reviewed Dr. Boisen's original conceptual scheme 

detail. Here a few brief excerpts from his book will 
tch the tenor of this thinking: 

The form of psychotherapy now most in the public eye 
is psychoanalysis. This in its aims is the exact opposite of 
faith healing. It has often been compared by its proponents 
to surgery, and major surgery at that. It is an attempt to 
' lay bare and bring into clear consciousness the disowned sex- 
ual desires and cravings which it assumes have become de- 
tached from the conscious self and are responsible for the 
s' neurotic symptoms. Its aim is to make over the harsh con- 
* science and the rigid ethical standards which have led to 
^ the disowning of these sex cravings so as to permit of their 
3 incorporation in the personality. To this end the psycho- 
analyst tries to get his patient to live through again his 

64 The Crisis in Psychiatry and Religiob 

early experiences. The entire procedure is designed to detach 
the patient from his early loyalties in order to enable hiq 
to build up a new philosophy of life in which the dissociatec 
cravings may be properly assimilated (pp. 243-44). 

In all my efforts [as a hospital chaplain and therapist] '. 
rely upon a simple principle ■ derived from my theologica 
training which seems to me far too little understood. I refe 
to the view that the real evil in mental disorder is not to h 
found in the conflict but in the sense of isolation or estrange 
ment. It is the fear and guilt which result from the presena 
in one's life of that which one is afraid to tell. For this rea 
son I do not consider it necessary to lower the consciena 
threshold in order to get rid of the conflict. What is neede( 
is forgiveness and restoration to the fellowship of that socia 
something which we call God (pp. 267-68). 

I would furthermore [suggest] that our findings indicafc 
that the sense of guilt, the self-blame and the emotional dij 
turbance which accompany it are not themselves evils bu 
attempts at a cure. The real evil is the failure to attain th 
level of adjustment called for in some new period of develop 
ment and the short-circuiting of the vital energies througl 
easy satisfaction (p. 281). 


In retrospect, we now know that the foregoing wer 
prophetic words. But they were not heeded. Instead, th- 
basic assumption of Freudian psychoanalysis — namel} 
that psychoneurosis arises, not from moral weakness o 
failure, but from an excessive and irrational severity (o 
"disease") of the superego or conscience — gradually pei 
meated and possessed the pastoral counseling movemeni 
One of the earliest and most transparent indications o 
this victory of the Freudian view, as opposed to tha 
advocated by Boisen, was the appearance in 1943 o 
Harry Emerson Fosdick's book. On Being a Real Persori 
Intended for laymen as well as religious leaders, thi 
book achieved an immediate popularity and widespreai 

In a chapter entitled "Handling Our IMischievous Cor 
sciences," Fosdick made his position clear: 

Indiscriminate praise of conscientiousness is psycholog 
cally dangerous. Many people worry themselves into coir 
plete disintegration over moral trifles, and others have cor, 
sciences so obtuse that they can get away with anything (|! 
133). I 

Challenge to Our Churches: i. Theory 65 

Conscience is a tricky function of personal life . . . with 
equal facility it makes saints, lunatics, and bigots (p. 133). 

Following one's conscience can be a distracting experience, 
and numberless people are torn to pieces by it (p. 134). 

We are supposed to sail by conscience and yet we cannot 
trust it; instead of relying on the compass to keep our 
course straight, we must keep our compass straight, and that 
makes nervous sailing (p. 135). 

Far from solving the problem of conscience, however, the 
acceptance of it is often only the beginning of our difficulty. 
Many do accept their consciences. They are disastrously con- 
scientious. . . . The psychiatrists' offices fill up with people 
whose consciences are on the warpath, harassing them with 
worry and remorse over small scrupulosities (p. 143). 

The mischief is that conscience can take advantage of its 
importance and can overbid its hand. . . . No good can 
come from this plus-activity of conscience, this hang-over of 
remorse; it spoils the life of the sufferer and darkens the 
skies of his family and friends. When conscience has fulfilled 
its function it ought naturally to stop, but commonly it 
persists, torturing its victim long after the torture has lost 
all value (p. 147). 

Moralism deals with symptoms and condemns results; psy- 
chotherapy diagnoses causes and is concerned with cure (p. 

Conscience makes multitudes of people miserable to no 
good effect (p. 153). 

That we need more conscientious people is a platitude, 
common but highly questionable. An immense amount of 
conscientiousness does more harm than good (p. 157). 

Although Dr. Fosdick conceded that behind some 
'morbid conscientiousness" and apparent scrupulosity 
iiere may be real guilt, he stoutly maintained — and in 
;o doing capitulated to the primal psychoanalytic premise 
—that in many other instances conscience is a real mon- 
>ter which complains and tortures the individual without 
just cause. 


In September of 1943, shortly after the publication of 
On Being a Real Person^ Dr. Boisen wrote Dr. Fosdick 
expressing his admiration for and appreciation of many 
reatures of the book but deploring its acceptance of the 
preudian doctrine of superego over-severity. Said Boisen: 

The statement on page 154 that the censorious con- 
science that can be blighting when used on others can have 


66 The Crisis in Psychiatry and RELIGIO^ 

a similar effect when used on oneself is undoubtedly true; nol 
so, however, the statement on page 152 that self-condemna 
tion is often the most misleading fact that can intrude itself. 
My observation is that the patient who condemns himself, 
even to the point of thinking he has committed the un- 
i V': pardonable sin, is likely to get well. It is the patient who 
'^ \ blames others who does not get well. The one is a benign 
^^3 reaction, the other a malignant one. Self -blame, even when 
^^ it leads to severe psychosis, means the recognition that some- 
thing is wrong and the acceptance of one's responsibility for 
the difficulty. The emotional disturbance which follows is; 
then analogous to fever or inflammation in the body. It is 
not an evil but a manifestation of nature's power to 
heal. . . . 

For example, take the hypothetical case you describe on 
page 150. You refer to the sense of guilt manifested by 
this young man as a "needless and harmful intruder." If 
the young man in question were like most of those I have 
known, the pent-up volume of guilty fears would be instru- 
mental in driving him to the minister's study and the relief 
he found there would come not so much thru anything the 
minister said to him as from what he said to the minister 
about a problem which for him was by no means a minor 

I wish that you might have done more toward clarifying 
the nature and function of conscience. Our psychoanalysts 
have discovered it and have much to say about it, but from 
my point of view their theories are far from adequate, while 
Dewey and Mead and Hocking are not given their rightfuli 
due. j 

In an article entitled ''Niebuhr and Fosdick on Sin,"! 
which appeared in the Chicago Seminary RegisteVj for! 
March, 1944, Boisen repeated and elaborated these con- 
cerns. However, he was unable to stenj the tide; and the 
Freudian notion that man sickens, not from sin but from 
excessive conscientiousness, continued to gain acceptance 
in theological circles. 


As already noted, there is tension today in our semi- 
naries and churches regarding the Freud-Fosdick position; 
but this position is clearly in the ascendancy, officially. 
Millions of ordinary church members have never accepted 
it, and many individual ministers and seminary teachers 
likewise deeply distrust it. But it has seemed that *'sc]h 

Challenge to Our Churches: i. Theory 67 

ence" was against them, and they have been reluctant 
to speak out for fear of ''contradicting science"; whereas 
those who beheved they were on the side of Psychological 
Truth have been boldly vocal. Their outspokenness could 
be illustrated at great length; but two recent examples 
will suffice. Dr. Carl Michalson, a professor of theology 
at Drew University, in the chapter on guilt in his Faith 
for Personal Crises (1959), writes as follows: 

Yes, the conscience (populady conceived) is as ready to 
condemn us as our most malicious enemy would be. Our 
conscience is a "prattler," bent less upon our regeneration 
than upon our destruction. ... It is our executioner, bent 
upon our destruction, only confirming our lie about ourselves 
and hiding from us the truth that we are in God's image, 
made to be responsible not to our conscience but to Him 
(p. 59). 

Christians are often scandalized by psychotherapists who 
seem to relax the moral standard in order to relieve the 
tension of their client's anxious guilt. The psychotherapist in 
this instance is a better interpreter of righteousness than 
many Christians are. . . . Moral flexibility may not in itself 
be healing but it does less damage than the tightening of 
the demands which are already cracking one's nature. There 
are times when aspirin is more healing than action. This 
is the gospel truth in "the power of positive thinking" 
(p. 61). 

And The Reverend George Christian Anderson, Direc- 
tor of the Academy of Religion and Mental Health, in 
the first chapter of his book Man's Right to he Human, 
echoes this now familiar refrain. He says: 

Today, psychiatry and the new sciences of behavior compel 
us once again to examine the precepts by which we live, 
shocking and enraging those whose houses were built on the 
foundations of their fathers (p. 15). 

We are now beginning to ask whether our wrongdoing 
is sin or caused by emotional illness. . . . Health of mind 
depends on whether we can let these forces ["powerful needs 
for love, raging hostility," p. 19] come out without feeling 
excessively guilty or frightened by what erupts from within 
(p. 17). 

The psychological journey into our inner world [by means 
of psychoanalysis] helps us to experience our emotions 
without fear, to admit what we have denied, and to deny 
what we once believed. Psychiatry obviously must reveal our 

68 The Crisis in Psychiatry and Religion 

morals, and measure the strength of the consequences of our 
rehgious faith (p. 18). 


Quite aside from the palpable desertion of traditional : 
Christian ideals and precepts which all such writings 
represent, there is the additional — and not inconsiderable 
— complication that secularists and scientists are them- 
selves now busily re-evaluating the whole Freudian Weld- 

In the book first published in German in 1938 and 
subsequently (1950) in English, with the title Technique 
of Analytical Psychotherapy, Wilhelm Stekel, an erst- 
while Freudian, wrote: 

I contend that orthodox analysis has reached a crisis 
which betokens that the end is near, that collapse is ap- 
proaching (p. xxiv). 

And after reviewing many case histories in which it is 
apparent that real guilt, rather than a mere "guilt 
complex," was at the basis of the manifest morbidity, 
Stekel concluded: 

I have had many cases of the kind, but have merely 
selected a few to show that parapathic [neurotic] disorders 
may be diseases of the conscience [in a new sense]. The 
patient suppresses his remorse, tries to drown the voice of 
conscience, and feigns immunity. Nature takes vengeance 
(p. 327). 

And more than a decade ago, quite unaware of the 
work of either Boisen or Stekel, the present writer (1950) 
was forced to take the following position: 

In essence, Freud's theory holds that anxiety comes from 
evil wishes, from acts which the individual would commit 
if he dared. The alternative view here proposed is that 
anxiety comes, not from acts which the individual would 
commit but dares not, but from acts which he has com- 
mitted but wishes that he had not. It is, in other words, a 
"guilt theory" of anxiety rather than an "impulse theory* 
(p. 537). 

What is the situation, in psychology and psychiatry, 
today? In another connection [Chapter 1], I have re- 
viewed prevailing psychiatric opinion concerning psycho- 

Challenge to Our Churches: i. Theory 69 

analysis, typical of which is the following statement by 
Dr. Lawrence Kubie (1956): 

We [analysts] have no right to be for or against anything 
in this field. We have a right only to the most complete 
humility — humilit}' that says we still know practically nothing 
about many important elements in the neurotic process or 
in the psychotherapeutic process (p. 103). 

Also in 1957, at its annual convention, the American 
Psychological Association, for the first time in its his- 
tory, sponsored a symposium on "Religion and Mental 
Health"; and in September, 1959, the same organization 
lield a symposium on 'The Place of the Concept of Sin 
in Psychotherapy" which attracted nation-wide attention 
[Chapter 3]. 


If theologians will take the trouble to examine care- 
Fully what is thus happening in the secular professions 
and sciences on which they have so heavily drawn for 
their new Psychology, they will find that something like 
1 revolution is in progress, which leaves them clutching 
Freudian doctrine to their breasts without either biblical 
or solid scientific support for it. The situation is well 
mmmarized in a paper ("Are Psychoanalysis and Reli- 
gious Counseling Compatible?") which the New York 
psychologist, Lee R. Steiner, read at a meeting of the 
Society for the Scientific Study of Religion, held in 
November, 1958, at Harvard University: 

It is my impression from twenty years of study of where 
people take their troubles and why tfiey seek out the sources 
they do,^ that the ministry makes a tremendous mistake 
when it swaps what it has for psychoanalytic dressing. 
Through the ages the ministry has been the force that has 
at least attempted to keep morality alive. It would be a pity 
if, in one of the eras of greatest moral crisis, the clergy 
should suddenly abandon its strength for something that has 
no validity, no roots, and no value. It is my impression that 
they would do far better to cling to what they have. Judaism 
has endured for almost 6,000 years. Christianity for almost 
2,000. Where will psychoanalysis be even 25 years from 
now? ... I predict that it will take its place along with 

^ See Steiner (1945), Where Do People Take Their Troubles? 

70 The Crisis in Psychiatry and Religion 

phrenology and mesmerism. Like them, psychoanalysis was 
the brain child of a highly inventive scientist, who was 
completely sincere in his belief that he was opening up a 
new world. We shall respect Freud for his efforts, as we do 
Gall and Mesmer. Like them, Freud had the germ of an 
idea which flared into a way of life for a time, but then i 

Today we can no longer honestly accept Freud as the j 
prophet which many theologians have tried to make of i| 
him. Instead, he is the Pied Piper who beguiled us into i| 
serious misconceptions and practices. In the sequel to- 
this article, I shall try to suggest ways in which the j 
churches and seminaries can recover lost ground in this I 
area and build for a sounder future. 

^ Cf . Dallenbach (1955). 


The New Challenge to our Churches 

and Seminaries: 

II. The Problem of Action* 

Here is a preliminary attempt to go beyond analysis 
and become action-oriented, to prescribe rather than 
merely diagnose. Any projected practical program always 
has to be tempered by circumstances and on-going ex- 
perience, but the two suggestions made herein are at 
least promising beginnings. A friend in Educational Ad- 
ministration used to be fond of saying that action in a 
practical situation is never straight-ahead-according-to- 
blan. It is always somewhat opportunistic, a slight advance 
here, an unexpected development or opportunity there. 
But movement can occur if there is a clear goal and 
steady pressure towards it. 

In I960 the World Council of Churches announced 
a conference on ways of revising and revitalizing religious 
worship — a subject implementing the concerns expressed 
in the following chapter. In March, 1960, the ministers 
of the First Community Church of Columbus, Ohio, 
held the first of a projected series of workshops on new 
ways to use religion, in conjunction with psychology and 
social science, to "remove blocks to personal growth." A 
little later the National Council of Churches held a con- 
ference, with several secularists participating, on the place 
of religion in higher education. These developments are 
representative of a new ''openness" to explore and change, 
if we can only lay hold of a sound and dependable ra- 

In Chapter 12 we shall go more deeply into some of 
the suggestions which are made in this chapter {see also 
Chapter S). 

In Part I of this article [Chapter 6], I have traced the 
brief history of the pastoral counseling movement and 

* Published in Foundations: A Baptist Journal of History 
and Theology, October, 1960, 3, 335-347. 


72 The Crisis in Psychiatry and Religion 

have shown it to have had four stages: (1) that of grow- 
ing awareness (on the part of Boisen, Fosdick, and 
others) of the failure of early 20th-century religion to 
speak and minister to man's psychological and emotional 
needs; (2) the initiation of the pastoral-counseling, or 
"clinical," movement (largely through the work of 
Boisen and his students) and Boisen's efforts, epitomized 
in his 1936 book, The Exploration of the Inner World, 
to give this movement a conceptual framework which 
would be congruent with the traditional Judeo-Christian 
ethic; (3) the blighting of this aim by the intrusion of 
the Freudian doctrine that human beings sicken in mind 
and soul, not from sin, but from their very excess of 
piety (or "moralism"); and (4) current developments 
in the sciences and secular professions which are casting 
grave doubt upon the validity of the Freudian view and 
thus placing many contemporary clergymen and semi- 
narians in the awkward position of having "sold their 

It now appears that Boisen was right, that psycho- 
pathology is a moral problem, through and through, and 
that it has gravitated into medical hands by default and 
complacency on the part of the Christian ministry and 
churches. Recently a church woman in Massachusetts 
wrote me a letter which she concluded by saying, "Cer- 
tainly if these ideas gain general acceptance, psycho- 
therapy would be revolutionized." On the assumption, 
substantiated in the earlier article, that these ideas are 
"gaining acceptance," we shall here explore some of 
the implications which follow for courses of action 
which our churches and seminaries can pertinently con- 
sider and, hopefully, pursue. 


In the preceding article, I have called attention to 
Dr. Boisen's 1926 article, "The Challenge to Our Semi- 
naries," in which he urged seminary students to do an 
internship in a mental hospital in order that they might 
bring "a new religious psychology" to the people and 
that "the Church may once more come into its own and 
speak no longer as the scribes and Pharisees and inter- 
preters of traditions but with authority of the knowledge 
of the laws of the life that is eternal" (p. 12). And I 
also cited the recent Niebuhr-Williams-Gustafson report 

Challenge to Our Churches il Action 73 

on The Advancement of Theological Education to show 
how widely this admonition is now being followed. But 
this new "clinical" program has been deflected from the 
course Dr. Boisen originally conceived for it and has 
taken on a strongly Freudian and neo-Freudian colora- 
tion. This, quite understandably, has created an uneasi- 
ness in our seminaries, which, however, has remained 
muted and is only now beginning to come out into the 
open. For example, in the report just cited, the authors 
guardedly say: 

Firsthand experience with persons in trouble is the basic 
material out of which Christian skill in care of souls must 
come. . . . Yet in spite of the ease with which this field 
can lead out and away from its theological center, there is 
a strong determination in the schools to keep the psycho- 
logical approach to personality in close relation to the 
Church and its faith. There is indeed considerable tension 
within some schools on the place of this field in the cur- 
riculum (p. 122, italics added). 

Clinical training programs need the schools not only for 
students and financial support but also as a source of con- 
structive criticism (p. 125, italics added). 

The pitfall is that [the student] may begin to "psycholo- 
gize" everything and try to solve every problem of faith 
through psychological analysis (p. 127). 


The present situation is, I believe, a very serious one 
and far from what Dr. Boisen originally intended. During 
the clinical internship and in propaedeutic seminary 
courses, students are typically schooled in the view that 
psychopathology is only indirectly a religious concern. 
They are deeply indoctrinated with the view that neu- 
rosis and psychosis arise from too much ''morality," 
rather than too little, and that the minister must care- 
fully recognize his "limitations" in dealing with such 

The total impact of this experience has, it seems, not 
been a good one. Typically, the student returns to semi- 
nary either confused, by the manifest contradictions 
between his religious heritage and psychological and 
psychiatric doctrines, or with the feeling that here, in 
psychiatry and psychology, is a redemptive ("therapeu- 
tic") power exceeding anything that religion itself can 
offer. The result is that if and when the seminarian, as 

74 The Crisis in Psychiatry and Religion 

parish minister, later undertakes pastoral counseling, it is 
with the feeling that his ''psychological methods" are 
something apart from his theology and Christian faith 
and that he can, at best, deal only with persons whose 
difficulties are relatively superficial. He is carefully in- 
structed, both by members of the secular healing profes- 
sions and by his own supervisors, on the importance of 
''knowing when to refer." In his own eyes as well as those 
of others, he is clearly a second- or third-class operator 
in this field; and even Niebuhr, Williams, and Gustafson 
bow to this prevailing state of affairs, when they say: 

We must add the warning that the student needs to 
learn the kinds of problems which require medical attention 
and which as pastor he should not try to handle. His minis- 
try is to the person in his religious need (p. 128). 

Has this type of program indeed taught our clergy to 
speak with authority, or as the scribes and Pharisees? ^ 


How ingrained the "psychiatric" view has become in 
the minds of many of our clergymen is reflected, with 
special clarity, in Anderson's recent book (also cited in 
the preceding article) entitled Man's Right to Be Hu- 
man, with the equivocal subtitle. To Have Emotions 
Without Fear. Here the stock position is reiterated, thati 
the psychologist, psychiatrist, psychoanalyst, social worker | 
— indeed, almost anyone — is better equipped to deal with 
serious emotional problems than is the minister. If, as 
we now have reason to believe, all psychopathology (of 
the functional varieties) stems from moral failure, how 
fantastic all this is! And yet many ministers have what 
may be termed a "trained incapacity" and educated 
reluctance to really come to grips with the problem of 
mental illness. Instead, they dutifully "refer," as indicated 
in the following excerpts from the book just cited: 

It was evident that Joe was suffering from a serious 
neurosis. As soon as Joe was gone I picked up the phone 

^ In an attempt to escape the pall of psychological and 
medical domination in this area, there is now a tendency on 
the part of some writers to speak of Pastoral Theology, rather 
than of Pastoral Psychology or Pastoral Psychiatry. But it is 
doubtful if a theological emphasis is so much what is needed 
as a sounder, more defensible psychological one, although it 
is realized that a valid absolute distinction here is not possible. 

Challenge to Our Churches n. Action 75 

and called a psychiatrist I knew and explained the situation. 
He agreed to see Joe the next day. ... I was able to make 
her [Joe's sister, with whom he lived] see that Joe was not 
as immoral as he was sick, and that he needed love and under- 
standing, and medical care, too, more than ever (p. 141). 

''Most men are beasts; only my Lord in heaven is worthy 
of my purity," she continued. I suggested that she come 
see me again, but in the meantime I referred her to a 
clinical psychologist for some vocational tests. ... It was 
obvious that the young woman was handicapped by a severe 
neurosis involving excessive guilt concerning her sexual feel- 
ings. Inasmuch as psychotherapy was indicated, the girl was 
referred to a psychiatrist who was able to help her accept 
her sexuality in a healthy manner (p. 172). 

A man came to see me about his wife's growing coolness 
toward him. . . . After counseling with both of them in- 
dividually, I discovered that the wife really loved her husband 
very deeply even though she abhorred his sexual claims. I 
referred both of them to a psychiatrist for further profes- 
sional help (p. 176). 

This is typical of what is supposed to be "good prac- 
tice" in the ministry today. And not long ago a young 
clergyman who had just come to our community informed 
me that he had been advised, in seminary, not only to 
be sure to "know when to refer" but also to be very 
careful in his sermons not to say anything that would 
make anyone "feel guilty." People have too much guilt 
already, he had been told; and if you talk about sin and 
guilt and moral responsibility from the pulpit, you only 
increase the danger of "neurosis." I wonder if this young 
man's professors know these lines from page 109 of T. S. 
Eliot's play, The Elder Statesman: 

You think that I suffer from a morbid conscience, 
From brooding over faults I might well have forgotten. 
You think that I'm sickening, when I'm just recovering! 


What the average theologian and religious worker ap- 
parently does not know and is reluctant to recognize is 
the extent to which the system of concepts and practices 
in which he has been schooled, during his training in 
pastoral psychology, is today in a state of deterioration 
and impending collapse. From the standpoint of those 
of us who know these developments from the inside. 

76 The Crisis in Psychiatry and Religion 

it is tragic to see the clergy continue to pay homage to 
what, in reahty, is rapidly becoming a hollow shibboleth. I 
For more than a decade, now, I have been pointing to 
the logical and empirical incongruities in psychoanalytic 
theory, on which so much psychiatry and clinical psy- 
chology is directly or indirectly founded; and in addition 
to my already published books and articles in this field, 
I invite the reader's attention to various reprints and 
mimeographed papers which will be supplied upon re- 
quest [now assembled as the chapters of this book]. 

But in these misgivings concerning psychoanalysis and ' 
the sense of untapped potential within the great tradi- 
tions and insights of religion itself, I am by no means 
alone, as has been indicated in the preceding article. 
And to that line of evidence I wish now to add further ' 
testimony of failure on the part of that profession in I 
which theologians have placed such supreme faith. Re-^l 
cently I was talking to a supervising psychologist in the I 
Veterans Administration who expressed the most pro- ! 
found disillusionment with prevailing psychotherapeutic 
methods and referred to VA mental hospitals as "sick 
institutions." And Dr. H. C. Solomon had this to say 
in the 1958 presidential address to the American Psy- 
chiatric Association: 

Large mental hospitals are antiquated, outmoded, and 
rapidly becoming obsolete. We can still build them but we 
cannot staff them; and therefore we cannot make true hos- 
pitals of them. ... I do not see how any reasonably objec- 
tive view of our mental hospitals today can fail to conclude 
that they are bankrupt beyond remedy. I believe therefore 
that our large mental hospitals should be liquidated as 
rapidly as can be done in an orderly and progressive fashion 

If my description is correct and my projections reasonably 
accurate, a new attack on the "care and custody" of the 
long-term ill must be attempted. Unpalatable as it may 
appear, one must face the fact that we are doing little by 
way of definite treatment of a large number of our chronic 
hospital population. It is not even the case that we are 
providing them with first-class environmental care, much less 
loving and tender care. Therefore, I suggest we take a new 
look at the problem (p. 8). 

Somewhat parenthetically and without elaboration, 
Dr. Solomon observes: 

Challenge to Our Churches ii. Action 77 

Our young physicians specializing in psychiatry are not 
heading toward our large hospitals, nor are the other cate- 
gories of personnel. In many of our hospitals about the best 
that can be done is to give a physical examination and make 
a mental note on each patient once a year, and often there 
is not even enough staff to do this much (p. 7). 

Despite government-sponsored subventions and schol- 
arships, the men and women who are today being trained 
in psychiatry are not going into state and VA mental 
hospitals for one major reason. It is not that the need 
is not great; they can make more money in private 
practice! There are, to be sure, some dedicated and 
idealistic psychiatrists and clinical psychologists. But the 
plain fact is that professional psychotherapy is, in general, 
iJ business; and if it turns out that what the patient 
jjecretly hopes to buy (and the therapist implicitly prom- 
ises to sell) is a cheap form of forgiveness and expiation 
![cf. Chapter 10], the "therapeutic" transaction is a very 
dubious business^as Katie Lee slyly implies when she 
ings (in "Shrinker Man"): 

I've been on one of those "complex" tours; 
I want you to make my problems yours. 
Now gimmie one of them cut-rate cures, 
Shrinker Man! 

Can an enterprise that thus measures in dollars and 
-ents its efforts to minister to sick minds and souls 
continue indefinitely to command our respect and con- 


If we have now accurately diagnosed the difficulty, 
vhat's to be done about it? In the over-all and ultimate 
;ense, I have to say that I do not know. Certainly the 
otal situation calls for courage, social inventiveness, and 
nsights which I do not possess. But I do have two sug- 
jestions to make. 

I think we now have to recognize that Protestantism 
las, on the whole, handled the problem of guilt very 
)adly and that the present critical situation is a natural 
;ulmination of four centuries of bumbling, indecision, 
.nd confusion on this score. As a first step, therefore, 
oward rectifying our predicament, I believe our churches 

78 The Crisis in Psychiatry and Religion 

ought, as Harry Emerson Fosdick argued (somewhat 
inconsistently) as early as 1927, to return to the practice 
of confession. We have tried to ignore and by-pass the 
very notion of guilt and sin; but it won't work. The 
gospel of sin and salvation (redemption) is not one of 
bondage but of liberation, hope, and strength; and we 
must, I believe, return to it in all seriousness. 

Pastoral counseling, as presently practiced, is, to be 
sure, itself a form of "confession," but it has two major 
weaknesses: (1) it is episodic, voluntary, and often 
belated and therefore lacks the preventive function which 
regular, prescribed confession (when practiced con-i 
scientiously and earnestly) has; and (2) "counseling" 
is now very largely patterned on secular psychotherapy,, 
with its emphasis on "acceptance" and "insight," and 
does not take sin really seriously. People do not merely, 
"talk" themselves into sin; they act. And by the same| 
token, I do not believe anyone ever talks himself out 
of sin. Again there must be action, and this action musti 
involve not only confession, of an ultimately open type, 
but also "atonement." Confession without a sober pro- 
gram of expiation can be dangerous, in the sense oi 
causing the individual to be overwhelmed with guilt andj 
self-hatred. And this is one of the unrecognized factors! 
that makes many present-day religious counselors soi 
insecure and unconfident. But if we can only understand! 
man's true "condition," ways will be found to overcome 
the apparent obstacles [see later chapters]. | 


My other suggestion has to do with a possible change 
in emphasis in the "missionary" concern of our churches 
and the problem of staffing our state mental hospitals, 
which has already been alluded to. 

The legal and social climate being what it is at present, 
clergymen are justifiably afraid to try to go "all the 
way" with emotionally disturbed persons. Sometimes 
it is virtually inevitable that an individual pass through a 
psychotic interlude (for reasons already mentioned) on 
his way to personal transformation and recovery. It is, 
of course, not uncommon for psychiatrists themselves tc 
have in treatment patients whom they eventually have 
to commit to mental hospitals. But if a person is seeing 

[Challenge to Our Churches n. Action 79 

1 religious counselor and becomes actively psychotic, the 
:ounselor is immediately vulnerable. He made the person 
^orse; he should have referred the patient; etc., etc. 

In an attempt to find a solution to this intolerable 
)ituation, a few denominations are experimenting with 
nental hospitals of their own. Without state support, 
these are, of course, extremely expensive to operate; and 
)uch reports as I presently have indicate that even these 
institutions rather pride themselves on the fact that they 
ire conducted along "approved psychiatric lines," rather 
than with any great new insight born of religious precept 
md conviction. 

Alternatively, I would like to see our chu'-^hes take 
mental hospitals as a major object of missionary effort. 
[sn't it a little awkward for us to be so concerned about 
the benighted state of those in foreign lands when the 
size and condition of our "insane asylums" stand out 
like great festering sores on the conscience of our own 
nation? I know a state mental hospital (not atypical) 
with, a population of 4500 patients without a single 
trained psychiatrist on the staff. Such physicians as there 
are, are immigrants or have for some other reason com- 
monly failed to obtain a state license for general medical 
practice. And there is one Protestant chaplain and one 
Catholic priest for this "town," where the religious and 
spiritual needs are surely far greater than in a normal 
community of comparable size. 

So why not let the churches also start at the other 
end of the line, with persons who have already hit bot- 
tom; who are in a protected environment, where the 
only direction they can move is up? Here the religious 
worker can be associated with a person's rise, rather than 
his fall. And imagine the gratitude, loyalty, and enthu- 
siasm which would be generated in persons who felt that 
religious insights and practices had saved them from the 
hell of mental illness! 

Elsewhere [Chapter 2] I have argued, with Boisen, 
that in neurosis and psychosis the afflicted individual is 
in a moral and spiritual crisis, and that in no other 
circumstances does the experience of God become such 
a vivid reality. (See also Frederick West's book. Light 
beyond Shadows!) But the common perception is that 
so-called mental "illness" really is an illness and has 

80 The Crisis in Psychiatry and ReligionI 

nothing to do with either God or the Devil. Is this 
progress or one of the greatest popular fallacies of all 
time? Can it be that we have come to doubt the very 
existence of Cod because we do not know where to 
look for Him and how to recognize His most tangible 
manifestations? ^ If churches today made a determined 
effort to come to grips with the problem of mental illness 
in this country, they could not only perform a great 
human service; they would also, I predict, discover a new 
and vitalizing force which will forever elude them at the 
more superficial levels of religious ritual and observance. 
As a friend of mine, who is a psychiatrist but also ac- 
tively religious, recently remarked, "Unless you face the 
demons, you never hear the angels!" 

^Cf. Robinson (1928). 



Psychopathology and the Problem 
of Guilt, Confession, and Expiation* 

If any one chapter is nuclear to this book as a whole, 
it is the present one. Here we come to grips, empirically , 
with the question: Does psychopathology involve real 
or only "imaginary" guilt? If the psychoneurotic' s guilt is 
not real, the whole argument collapses. If it is, then the 
necessity for a long and complicated series of ideological 
and institutional changes weighs heavily upon us. 

Some readers, upon completing this chapter, may feel 
dissatisfied at the absence of any effort to provide a 
formal definition of ''real" guilt, sin, evil. Concern with 
this problem will come in due course. But what is more 
immediately important, it seems, is to get some feel for 
the raw data. Without a strong sense of the pragmatic 
and factual, definition making can be both tedious and 

The case material and other clinical evidence here 
cited is not, of course, submitted as definitive ''proof" 
of a universal or absolute principle but only as illustrative 
of a possibility. Already there is a decided inclination to 
concede that real guilt can be determinative in person- 
ality disorder. The question is whether it always is. The 
present writer is entirely willing to leave the answer to 
this question open, pending further research and expe- 
rience. But even if guilt is real {rather than illusory) 
in only half or a third of all personality disturbances, it 
still constitutes an enormous practical problem, with 

* In addition to serving as the first of the E. T. Earl Lectures 
at the 1960 Pastoral Conference sponsored by the Pacific 
School of Religion, February 23-25, in Berkeley, California, 
this paper was read before the St. Louis Society of Neurology 
and Psychiatry, April 1, 1958, and at the Symposium on 
Current Trends in Psychology held by the University of Pitts- 
burgh, March 12-13, 1959. It has also been pubhshed ir» 
Current Trends in Psychology, X, University of Pittsburgh 
Press, 1960. 


82 The Crisis in Psychiatry and Religion 

which neither the churches nor secular professions are 
presently dealing at all adequately. And if it should 
turn out that real guilt {however disguised or displaced) 
is the chief etiological factor in all psychopathology^ the 
situation will be still more disconcerting and challenging. 

Historically the prevailing view, in literature and non- 
literate societies alike, has been that man sickens in 
mind, soul, and perhaps even body because of unconfessed 
and unatoned real guilt — or, quite simply, from what 
an earlier era knew as a state of ''disgrace" or "sin." 
However, as a result of complicated historical reasons 
which have been explored elsewhere [Chapters 9 and 11], 
this view has, in our time, fallen into disrepute. The 
church, badly weakened by internal strife and injudicious 
opposition to science, quietly relinquished its traditional 
claim to competence in the domain of the sick soul and 
unprotestingly accepted the emphasis of 19th-century 
psychiatry on constitutional and biochemical factors. 

It was, therefore, in this remarkable setting that 
psychoanalysis had its inception and rapid growth. As 
Freud observed in his autobiography (1935), toward the 
end of the last century there were, in every large European 
city, "crowds of neurotics, whose number seemed further 
multiplied by the manner in which they hurried, with 
their troubles unsolved, from one physician to another" 
(p. 27). The church had, in effect, turned a deaf ear to 
the needs of these people; and the common forms of 
medical and psychiatric treatment, which were predicated 
on a somatic conception of personality disorder, were 
I magnificently ineffective. The situation thus called for a 
' boldness which Freud supplied in the form of a clever 
compromise between the traditional moral view of per- 
sonality disturbance and medical preconceptions. Cuilt, 
he hypothesized, was indeed a factor in neurosis but it 
was a false, unrealistic, and crippling guilt which, as a , 
result of a too strict and restricting socialization of the 
individual, impeded the normal flow of certain instinctual 
energies, notably those of sex and aggression. So the 
psychoanalytic physician set out to cure neurotic individ- 
uals by championing the rights of the body in opposition 
to a society and moral order which were presumed to be 
unduly harsh and arbitrary. 

Guilt, Confession, and Expiation 83 

There was, of course, no lack of individuals who were 
willing to be saved by this plausible-sounding and pleas- 
ant philosophy — and who were willing to pay for it, 
handsomely. Thus, both patients and practitioners of the 
art were assured. But the day of reckoning is upon us. 
Our mental hospitals are now, alas, full of persons who 
have had this new form of treatment and not profited 
from it; and among them, their erstwhile therapists, and 
the general public alike there is growing disillusionment 
and alarm. Once again we are in a period of sober reap- 
praisal; and it is the purpose of this paper to suggest 
one way of re-thinking the problem which, although in 
some respects very costly, nevertheless promises a form 
of redemption more radical and generally applicable than 
anything we have known in the recent past. 

As the title of this paper implies, it will be our plan 
to consider, first, the possibility that in psychopathology 
guilt is real rather than illusory ("delusional"); then we 
shall explore the correlative proposition that the aim of 
communication and self-disclosure in the therapeutic sit- 
uation is not mere understanding and insight (in the 
Freudian sense of these terms) but a changed, repentant 
view of oneself; and finally we shall examine evidence 
for believing that, however necessary they may be, con- 
trition and confession are not alone enough to restore 
psychic and moral equilibrium and must be followed by 
meaningful, active forms of atonement or restitution. 


Freud held that, as a result of a too intensive socializa- 
tion, some individuals develop so great a fear of their 
sexual and hostile feelings that, eventually, they even 
deny these feelings access to consciousness and that it is 
the alarm which the ego feels when these impulses clamor 
for recognition and expression (i.e., the danger, as Freud 
called it, of the ''return of the repressed") that generates 
the characteristic neurotic affects of depression, anxiety, 
and panic. In 1950 the present writer (see Chapters 
18-22) hypothesized that in neurosis it is actually the 
individual's conscience that has been repudiated and 
"repressed" rather than his "instincts," thus shifting the 

84 The Crisis in Psychiatry and Religion 

emphasis from Freud's impulse theory of neurosis to a 
guilt theory. Actually, as is now evident, this position had 
been anticipated by Runestam (1932), Boisen (1936), 
and Stekel (1938), and it now seems to be steadily 
gaining in acceptance. However, the doctrine of repres- 
sion, upon which the difference in opinion here hinges, 
is a subtle one and not easily amenable to objective 
verification, so the issue has remained a debatable one 
[see Chapter 2]. 

But there is another way of putting the problem which 
makes it more immediately researchable. According to 
Freud and his followers, the neurotic is in trouble, not 
because of anything actually wrong which he has doney 
but merely because of things he would like to do but, 
quite unrealistically, is afraid to. By contrast, the other 
view is that in neurosis (and functional psychosis), the 
individual has committed tangible misdeeds, which have 
remained unacknowledged and unredeemed and that his 
anxieties thus have a realistic social basis and justification. 

So conceived, the difference between the two positions 
can be empirically studied with soirie precision. Accord- 
ing to the Freudian view, the neurotic should have a 
history of something like saintliness; whereas, according 
to the other position, he should have a record (albeit 
a carefully concealed one) of actual and incontestable 
misconduct and perversity. This issue should by all means 
be submitted to systematic investigation on a scale cor- 
responding to its significance. But I confess that, for 
myself, I am already pretty well persuaded what the 
results would be and will here merely cite a few examples 
of the kinds of evidence which is already widely available 
on this score and which I, personally, find convincing. 

In the summer of 1956, a manuscript was transmitted 
to me which has now been published in the Journal of 
Abnormal and Social Psychology (Anonymous, 1958), 
for which I wrote the following brief introduction. The 
paper, I should say, is entitled "A New Theory of Schizo- 

This remarkable paper was written some two years ago 
by a then 34-year-old man residing in a closed ward in one 
of our large VA hospitals with a diagnosis of "paranoid 
schizophrenia." Soon after the original manuscript came 


Guilt, Confession, and Expiation 85 

into my hands (through a former student), I had it mimeo- 
graphed and, in the interim, as occasion arose, have obtained 
reactions thereto from several chnical psychologists, psy- 
chiatrists, and theologians. The evaluations fall into two 
categories: some hold that the paper is just what it purports 
to be, an original and highly reasonable theory of schizo- 
phrenia — ^while others insist that it is a classical exhibit of the 
disease itself. 

The present judgment of the author, now no longer 
hospitalized, is that his paper, as it stands, is probably valid 
as far as it goes but needs to be elaborated and extended in 
certain ways. It is hoped that his further thinking in this 
connection can be separately published at a later date. In 
the meantime, readers will be free to form their own opinions 
as to whether the production presented herewith is an essen- 
tially valid, albeit perhaps partial, theory of schizophrenia — 
or just a "phenomenological perspective." . . . 

Here it need only be added that the author of the follow- 
ing essay has a history of personal waywardness and perver- 
sion (hence the anonymity) which could easily support his 
original thesis. He regards the present document as largely 
an expression of unconscious processes, rather than as some- 
thing that he carefully reasoned out. It was written, he says, 
"while I was still following signals and colors; some of it was 
almost automatic writing." The author gives additional infor- 
mation about himself at the end of the paper. 

Before proceeding with a synopsis of the paper proper, 
it will be well to present the following information, 
ivhich the author himself gives as his "qualifications" for 
ivriting such a paper. He lists them thus: 

Nearly four years of psychotherapy. 

Nearly two years of living in mental hospitals. 

Observation of my mother, who is now hospitalized for 
the fourth time. 

Twelve to fifteen years of self -analysis. 

A B.A, degree and one year of graduate work in psy- 
chology with philosophy as a minor. 

99th percentile on the Graduate Record Examination in 

A nearly life-long desire to contribute to knowledge, espe- 
cially to solve the problem of mental illness. 

But now, to return to the essay itself. Near the outset 
the author — whom we shall know as Tim Wilkins — 

86 The Crisis in Psychiatry and Religion 

I propose that the motive force of schizophrenic reactions 
is fear, just as fear motivates, according to Freud, neurotic 
mechanisms — but with this difference: in the case of schizo-, 
phrenia, the chronic fear is more properly called terror, ot 
concealed panic, being of the greatest intensity; and second! 
as is not the case in neurosis, the fear is conscious; thirdJ* 
the fear itself is concealed from other people, the motive of 
the concealment being fear. In neurosis a sexual or hostile 
drive, pointing to the future, is defended against. In schizo- 
phrenia, by my view, detection by others of a guilty deed, 
the detection pointing to the past, is defended against 
(pp. 2-3). 

One of the things that gives this document particular 
authenticity, for me, is the way in which the author here 
accepts, without question, the validity of Freud's theory 
of neurosis but then goes on to report his own very 
different inductions about schizophrenia. By 1946 or '47, 
when Wilkins had his last contact with academic psy- 
chology, the Freudian theory of neurosis was still very 
much in vogue; and, writing in 1956, Wilkins seems to 
have been quite unaware how widely that theory was 
being replaced by an alternative view quite similar to his 
own. The fact that Wilkins apparently did not know 
of these developments, as far as the theory of neurosis 
was concerned, therefore gives his formulations concern- 
ing the schizophrenic psychoses special cogency and 
independence — and constitutes, perhaps, still another 
indication of the weakness of the classical Freudian posi- 

But what, more specifically, is Wilkins' theory of 
schizophrenia? As much as possible it will be presented 
in Wilkins' own words. 

My hypothesis [says Wilkins] may be called the Dick 
Tracy theory loosely in honor of the familiar fictional,] 
human bloodhound of crime. I 

Motivated in the very first place by fear, the schizophrenic 
psychoses originate in a break with sincerity, and not in the 
classically assumed "break with reality." The patient's social 
appetite (an instinctive drive in primates, I believe), includ- 
ing love and respect for persons and society, is consciously 
anticathected or forsaken and ultimately repressed with the 
passage of time, since full satisfaction of sociality entails, 
more or less, communicative honesty, faith, and intimacy. 
Also, the tension set up in interpersonal intimacy by the 

[^uiLT, Confession, and Expiation 87 

withholding of emotionally important (although perhaps 
logically irrelevant) information causes unbearable pain. This 
repression of sociality accounts for the well-known "indif- 
ference" of schizophrenics. But if safety can be achieved by 
means of "perjury" alone without great discomfort, then 
no further defenses are adopted. Perjury is here defined as 
avoiding telling the whole truth and nothing but the truth. 
If, for many possible reasons, perjury is not an adequate and 
comfortable guarantee of safety, as it usually is not, then 
"cutting" of social contacts is progressively pursued — all in 
the interest of safety in respect to avoiding possible punish- 
ment. Suppression and repression of the social appetite or 
instinct is thus central to schizophrenia. I believe that repres- 
sion of sexual and hostile drive is not primary in schizo- 
phrenia, although it is secondary, as will be explained further 

Schizophrenia is the cultivation of a lie. A lie is "proved" 
to be the "Truth." The real truth is that the schizophrenic 
is responsibly guilty for some crucial misdeeds. . . . 

In my view a large amount of the damage to the schizo- 
phrenic's self-esteem results from his contemplation of his 
own vicious insincerity — which damage is more an effect 
than a cause of his disease. His unethical defense mechanisms 
cause him deep shame and fear of loss of others' esteem. 
In addition, the primary deeds — ^whose exposure and punish- 
ment are avoided by the disease — are shameful. . . . 

More broadly speaking, schizophrenia shares with all func- 
tional mental illness the ultimate danger of punishment 
meted out by men, demigods, or gods. Common punish- 
ments feared are the being deprived of love of kith or kin, 
loss of social status, financial security, etc., and especially 
in the case of schizophrenia the more violent punishments 
such as being abominated by kith or kin, bodily mutilation, 
imprisonment, lynching, execution. 

This abandonment of social ties and good feeling, in the 
interest of personal safety, is sometimes starkly simple, as in 
mutism, but is usually supplemented by the development of 
"phony" social behavior, that is to say, designedly cryptic or 
misleading expressions of interests, sentiments, opinions; de- 
signedly unfriendly "friendliness;" asking only questions to 
which the answers are already known; the limitation of 
conduct to carefully self-criticized, self-rehearsed stratagems, 
etc. The patient has aggressed, ultimately in self-defense, by 
means of an undeclared, passive, preventive "war" against 
his fellow men, and in the interest of preventing defeat 
(positive victory is soon sensed to be hopeless of attainment) 
most of his knowledge and sentiments, and indeed his spon- 

88 The Crisis in Psychiatry and Religion 

taneous behavioral tendencies, have been classified "top 
secret." Whatever words he actually uses are employed, thus, 
as self-defensive weapons. My Dick Tracy theory offers the 
explanation that high reaction time results from "biding 
time" in the service of caution.^ Time is needed in order to 
creatively choose a "phony" (not spontaneous, not honest, 
not satisfying — except with respect to fear) response that 
will maximally conceal the patient's mental life and thus 
insure safety. 

A semi-instinctive deceptive stratagem leads schizophrenics, 
like pursued rabbits, to "zigzag," thus baffling the pursuer's 
expectations. Unpredictability is the stock-in-trade fetish of 
schizophrenics. The proximate goal is to avoid being under- 
stood. The ultimate goal is to avoid punishment. They "non- 
want" punishment (pp. 227-228). 

My hypothesis diverges from orthodox theory, I believe, 
in insisting that a large part of the schizophrenic's fear is not 
a symptom and is not repressed, but is the main pathogenic 
force and is accessible to consciousness and even verbalization 
were the psychotic to violate his more or less conscious policy 
of dissembling. 

There are understandable reasons why others may not have 
developed this view sooner. The theorist is naturally made 
to appear somewhat hard-hearted and accusatory [see Chap- 
ter 21. The famihes and others related to the schizophrenic 
would naturally resent the implication of crime. . . . [And] 
it is easy to imagine and believe that physicians and psy- 
chologists would not enjoy making a career of being acces- 
sories after the fact or having their work open to such inter- 
pretation in the sociological "climate" afforded by present- 
day attitudes. Nor would professional healers in general 
enjoy arranging for prosecution of patients. 

In other words, this theory, even more so than Freud's 
sexual emphasis, by its very nature would stand to be un- 
popular aU around, both to the patients and the healers and 
the social group which surrounds them both. In fact, were 
it not that the truth promises to be practically invaluable 
in the long run, I would hope that my theory is not true. 

As Freud found Shakespeare's Hamlet to be representative 
of neurosis, I take Shakespeare's Lady Macbeth to typify 
schizophrenic psychoses. The motto of the schizophrenic 
might well be, "Out, damned spot!" and that of the therapist 
working with schizophrenics, "Find the crime!" (p. 228). 

^The author is here alluding to a study of reaction time in 
schizophrenics with which he was familiar. 

Guilt, Confession, and Expiation 89 

There then follow sections with these titles: "Schizo- 
phrenia and Criminality Compared," "On Crime and 
Punishment," "The Theory and Types of Schizophrenia,*' 
and "Schizophrenia, A Social Disease," in which further 
empirical evidence is mobilized in support of the theory 
and implications drawn which might be tested by further 
inquiry. And, toward the end of the section last cited, 
ive find this wistful yet trenchant passage: 

My theory makes schizophrenics out, in a sense, to be 
villains. Yet obviously they would be bungling villains, and 
the very botching of their lives strongly suggests forceful 
extenuating circumstances, since without tremendous pressures 
people seldom, presumptively, destroy what they love as 
much as all people love themselves originally. 

Irrelevantly, it is pleasant to say that human beings are 
lent dignity (of a rather evil sort, if my theory is true) if one 
credits the schizophrenics of the human race with being 
real people who have fallen into disease by having failed to 
make the right decisions at the right time in regard to 
problems which even our philosophers and theologians have 
not solved in the quiet of their studies with the help of 
the written words of many other minds — while the schizo- 
phrenics failed under enormous, frantic pressures, as is typ- 
ically the case (p. 233). 

Then there is a section entitled "Thoughts on Ther- 
ipy" and, finally, a "Summary," which reads, in part, 
IS follows: 

So what is a schizophrenic? In brief, he is a terrified, con- 
science-stricken crook, who has repressed his interest in 
, people, unavowedly insincere and uncooperative, struggling 
I against unconscious sexual perversion. He is of no mean 
j Thespian ability. And his favorite Commandment is that 
which one nowadays facetiously calls the Eleventh Com- 
mandment, "Thou shalt not get caught." 

Attempts to expose him may only drive him further 
"underground." But a knowledge of his true nature will 
surely lead, someday, to somebody's discovering a sure, quick, 
effective and enduring cure (p. 236). 

As already indicated, there are those who insist that 
he sense of guilt and wrong-doing which the author of 
his paper stresses is itself pathological; and some would 
ven hold that the misdeeds to which the schizophrenic 

90 The Crisis in Psychiatry and Religion 

person points, if real, are an early expression of disease, 
rather than a cause thereof. But this position has the 
logical defect of making all misconduct interpretable in 
this way and thus obliterates the whole concept of per- 
sonal and moral responsibility. Moreover, there are now 
psychiatrists, including some very eminent ones, whO; 
feel that this view is unsound even when limited to the; 
most obviously *'sick" individuals and that an entirely 
different orientation is needed. For example, after the, 
publication of Tim Wilkins' paper, Dr. Karl Menningei 
(1958) wrote as follows: 

I very much liked the article on schizophrenia ... in the 
September issue of THE JOURNAL OF ABNORMAI 
AND SOCIAL PSYCHOLOGY. I wish you would tell [the 
author] that I think it is fine and that it would be even 
little better, in my opinion, if he would not try to distinguis 
between schizophrenia and other groups of symptoms. Essen 
tially all mental illness must be a reaction to some kind o 
feeling of rupture with the social environment, and of course 
it is typical of many patients to identify this with their owi 
aggressive intent or even aggressive acts for which, as [th< 
author] says, they feel guilty and about which they ar« 
defensive and evasive and insincere. 

Or consider this observation, reported by Hock 
Polatin (1949) in connection with their study of a larg 
group of borderline — or what they prefer to call "pseudo 
neurotic" — schizophrenics : 

In all the writers' cases, they observed that the patien 
usually told of a great many sexual preoccupations showin 
autoerotic, oral, anal, homosexual and heterosexual tendencie: 
and ideas which sometimes resembled a textbook of ps) 
chopathia sexualis. These polymorphus perverse manifest 
tions, this chaotic organization of the patient's sexuality, tb 
writers feel, is rather characteristic of these schizophreni 
cases. Marked sadistic or sado-masochistic behavior is ofte 
linked with this sexual material. This is especially true i 
patients who rather overtly and without restraint, expre: 
incestuous ideas. Many of these patients, especially und( 
sodium amytal, verbalize these ideas freely, or express thei 
freely in drawings (p. 253). 

Recently a state hospital conducted an all-day institui 
for clergymen for which the head of the Social Servic 
Department had prepared a case history of a 33-year-o] 

Guilt, Confession, and Expiation 91 

woman who, it was felt, rather well typified entering 
patients. For a period of two years, this woman had been 
having an affair with her brother-in-law; she had on one 
occasion assaulted her husband with a butcher knife; 
and on another occasion had thrown a small child over 
a backyard fence. Finally she became suicidal and had 
to be hospitalized. 

And so might one continue, indefinitely, to mobilize 
bvidence that sin and emotional sickness are no strangers 
to one another and that it is only by flagrant disregard 
oi the clinical facts that one can imagine that neurotic 
and functionally psychotic individuals have been too 
:horoughly socialized and are the victims of an unduly 
evere, oppressive morality. Therefore, although it is 
Realized that the evidence cited will probably not be 
ufficient to convince anyone holding a strongly contrary 
^^iew, it will be accepted here as typical of a much larger 
body of facts which justify further consideration of the 
dew that mental illness is a social and moral illness and, 
in the final analysis, capable of remediation only along 
social and moral lines. 


If it be true that emotionally ill persons are typically 
guilty persons, i.e., persons with real guilt rather than 
mere guilt feelings^ the question very naturally arises as 
:o what can be done to alleviate such a state of affairs. 
Everyone apparently has an intuitive compulsion to 
idmit, or confess, his guilt to others; but this is a very 
Dainful act and is likely to occur only under great 
irgency. A dramatic itistance of confession, and the 
conflict it involves, is given in the following paragraphs. 
rhey are taken from Standal & Corsini's (1959) book, 

ritical Incidents in Psychotherapy. I may say that 
Jie counselor here reporting is not identified, and the 
client is known only as ''Jo^'^-" The counselor begins by 
^ving the background facts: 

Joan is a nineteen year old college freshman. She was first 
seen while she was attending Junior College. The school 
psychologist had diagnosed her as a Paranoid Schizophrenic 
on the basis of a Rorschach test and had referred her for 

92 The Crisis in Psychiatry and Religion 

psychotherapy to a counsehng center which uses a chent 
centered approach. 

The therapist to whom Joan was assigned (the preseni 
author), noted no psychotic symptoms until the sixth inter 
view when she had an hallucination and expressed some 
bizarre ideas. After this interview, the therapist asked for £ 
consultation with a psychiatrist which was followed by a joini 
interview with the patient and continuing consultation durin§ 
the course of treatment. 

The critical incident described occurred in the fourteentl: 
interview. Joan had been seen initially for eight interviews 
followed by a month and a half of summer vacation, anc 
then five more interviews before she left town to go to i 
state university. She had been at the university for one weel 
when she called the therapist and said she wanted to com( 
back during the weekend for an appointment. One was sel 
for five o'clock on Saturday. 

Joan arrived almost on time, breaking a precedent oj 
coming consistently twenty to thirty minutes late. She saic 
she was quite disturbed and had tried to reach me twic{ 
during the afternoon but I wasn't there. 

I asked her how much time she would like. (Our previou: 
interviews had all been for whatever was left of fifty minute: 
after her late arrival.) I opened the possibility of a longei 
interview in reaction to her apparent degree of disturbance 
and the inaccessibility of the clinic to her new residence aij 
the university. She asked, "What do you mean?" I said, "Ij 
wonder if you would like more than an hour today?" Sh(i 
said, "Yeah, I would." I asked her, "Well, how much tim^i 
would you like?" She did not try to answer the questioi! 
so I said, "Suppose we continue until we both get hungrj 
and it's time to go home for supper." 

She began then talking about her experience at the univer 
sity. She described the loneliness that she felt — the isolation 
Nobody really loved her. She just felt all alone in the world 
Life was so depressing that she couldn't work up interest ii 
anything. She didn't have the push to do anything. If sh( 
had the push, she thinks she would commit suicide. If th( 
future were merely an extension of the present, then r 
would not be worth living for. She was expressing a deej 
despair when she began to pull herself together again. Theo 
would be some hope if she could change herself. She begai 
to feel that maybe she did have the possibility for changing 

During a pause in this working through of feeling, '. 
wondered about the time. Taking out my watch, I discov 
fxed that it was six-thirty and that we had been togethe. 
for an hour and a half. I put my watch on the desk anc 
asked her, "How much more time do you want?" She didn' 

!JuiLT, Confession, and Expiation 93 

answer. The watch sounded loud ticking away, so I put it 
back in my pocket. We went on until about seven, when I 
, began to feel weak and wasn't following her very well. I 
said this to her and she looked up at me like a scared rabbit. 
She smiled in a forced way and began putting on her coat 
j as if preparing to leave. I said, "You looked frightened when 
I I suggested it might be time to stop." She nodded. I said, 
! "Almost as if you thought I was rejecting you then." She 
said, "Yes, that's what it looked like to me." Then she pulled 
i her coat together over her chest. Her hands clenched strongly 
on the coat and she started to stare at the wall. Her eyes 
got red but no tears came. She began to tremble. I did not 
understand what was happening and said, "It seems as if 
the feelings you have now are making you afraid." She just 
nodded without looking at me. Her trembling and staring 
went on for about eight minutes. Then she stood up in 
front of me. I asked her if she wanted to go home. She 
looked at me, smiled again in a mechanical fashion and 
shook her head "no." Then she began wringing her hands, 
staring at the wall and shaking all over. From time to time 
her body would lean toward me and then lean away. My 
heart was beating like a trip hammer. I didn't understand 
what was happening to her. I was afraid that she might be 
going into a psychotic break. After about ten minutes of 
throbbing silence, I said, "It's hard for me to understand 
what you are feeling." Then she said that she was looking 
at the lambs on the wall, the faces of the lambs. (There 
was a flower print on the wall.) "They have two eyes. One 
is a mean eye and the other is a kind eye. I see the faces of 
my mother and my grandmother. They are telling me to 
control myself and I hate them" (pp. 38-40). 

When I have previously presented this material orally, 
have usually stopped at this point and asked for the 
ipressions of others as to what, precisely, was going on 
2re. Even a group of laymen will come through with 
fairly accurate appraisal. They will see, first of all, the 
^inly veiled seductiveness of the client: her avowed 
neliness and vagueness about when she needs to leave, 
^hen the therapist tries to force the latter issue, Joan 
oked frightened, hurt — and he interprets this, probably 
lite correctly, as indicating a feeling on Joan's part of 
?ing "rejected." Clearly the counselor had rejected Joan 
regards any sexual advances that she may have been 
aking to him. With the situation thus clarified and 
estructured," things began to happen. Almost imme- 

94 The Crisis in Psychiatry and Religion 

diately, "she pulled her coat together over her chest. He 
hands clenched strongly on the coat and she started t( 
stare at the wall." Presently she stood up in front o 
the therapist and physically acted-out her conflict b' 
alternatively leaning toward and away from him. Thei 
she hallucinated. Eyes are a proverbial symbol of author 
ity and conscience, and Joan reflects her ambivaleno 
toward them by seeing one of the eyes of each lamb* 
face as good, one bad. Then Joan sees the faces of he 
mother and grandmother — faces, so to say, which wer 
''behind" conscience. *They are telling me to contro 
myself and I hate them." The fact that moral authoriti 
had here been internalized but not assimilated is thuj 
apparent; and it is noteworthy that such authority ij 
depicted as exclusively female — there is no fatherly fac 

Having thus paused the better to grasp this rapid 
moving and dramatic scene, we now return to th 
counselor's narrative. 

I told her I was puzzled. Then I said, "I wonder if yo 
are saying — in part you like yourself, in part you don't li 
yourself." She said, "No. It's other people's reactions to mf 
They partly like me and partly don't like me." She said thz 
one of the eyes was covered over with wool. I said, 
wonder if you are saying that if people really knew you- 
could see the real you — that they would not like you." Sh 
said, "Yes." ' 

In between these times when we talked together, she WJ 
still standing, trembling, wringing her hands and staring 
the wall. Then she began to tell me, in a very circuitoi 
way, about her relationship with her father. She started oi 
by saying that when she was thirteen years old, she ha 
seen the divorce papers of her parents. In those papers 
said that her father had not wanted her before she was bon 
Then she went on to describe her father's attitude towai 
her and after many hints told me about having had incestuoi 
relations with her father. She described this as the experiem 
which has made her dirty, no good, horrible. 

She had been standing and shaking for half an hour bi 
having brought out this report of incest, she sat down an 

^No explicit reference is made here, by either the client i 
the counselor, to the common expression, "pulling the wool 
over another's eyes as a metaphor for deception; but it seen 
to have been mutually understood and accepted. 

^uiLT, Confession, and Expiation 95 

relaxed. She looked at me while she talked, really seeing me 
for the first time since she had stood up and described how 
this experience had affected every part of her life. She had 
never told this to anyone before. She felt she could not tell 
her mother or her grandmother. Even with her father, she 
pretends that it had never happened and he never mentions 
it. She no longer has sex relations with him but when she 
visits him (her parents are separated) she takes along a 
friend to protect herself. 

When it was about eight o'clock, I found I was again 
beginning to get hungry. I said, "Well, I'm beginning to 
get weak again." She said, "You know, I've got a headache 
and I'm hungry. I'm just all worn out and I really haven't 
much more to say today. But I couldn't tell you. I couldn't 
suggest that we stop." It developed that she was afraid that 
that would be rejecting me. 

Again it takes no special intuitiveness to see what had 
ccurred here. Joan had come to the interview conflicted 
etween the possibility of admitting the incestuous rela- 
onship with her father and of replicating it, with the 
Dunselor. What she would have actually done had the 
Dunselor gone along with the first possibility we can 
nly conjecture — first of all because this is not what 
appened and secondly because, if it had, there would 
ave been no record of the case, or at least not one 
3luntarily supplied by the counselor! But the mystery 

still not completely solved. Why does Joan have to 
ngle out this particular man? Surely there were both 
lore appropriate and more accessible sex objects in even 
er impoverished social environment than this obviously 
:der, presumably married, and professionally responsible 
[dividual. Actually, the very paradox provides the key. 
)an arranged this Saturday-afternoon tryst with the 
)unselor, not because she was sexually starved, but 
2cause she was morally oppressed; and if she could 
ave seduced this father figure, as she had her original, 
.ological father, she would have won at least a transitory, 
lOugh ultimately bogus, moral victory of considerable 

'Only those without experience in the psychotherapeutic 
:uation will regard the sexual interplay here implied as either 
lusual or misperceived. The only question is one of interpreta- 
)n, "dynamics," meaning. 

96 The Crisis in Psychiatry and Religiq 

Certainly it was no accident that her father's face wj 
not among those staring out at Joan from the wall- 
and from the past. As a father he was dead — and Joa 
had helped kill him. Having with Joan's cooperatio 
irreparably disgraced and disqualified himself for tk 
role, he could no longer *'face" her. But the mothti 
and the grandmother had not been so effectively dispose 
of; and although Joan hated them, they gave her no res' 
So on this fateful Saturday afternoon, Joan came nc 
awooing in any usual sense of that term, but rather wit 
confused and mixed intentions of confession and "mu: 
der." But her possible victim was this time immune t 
her devices. When confronted by a hardly mistakabl 
sexual invitation, all he did was to talk about how wea 
and hungry he was feeling! And he was right in perceiv 
ing that Joan, or at least a part of her, did "feel rejected. 
This time Joan had met her match; this father wa 
incorruptible. And she had the courage and characte 
to make the most of it: to him she then confessed. Sh 
had "tried" him, and he had qualified for this differen 

There is only a little more to the counselor's account 
He concludes by asking a series of questions: 

What part did the handling of time play in this interview 
Did the indecisiveness of the therapist lead to a seductiv 
interplay which aroused transference reactions, helping t 
precipitate the temporary psychotic break? If so, how shouL 
this be evaluated therapeutically? Would a firm initia 
definition of limits by the therapist have cut off the possi 
bility of the intensive catharsis which occurred during th 
last hour? j 

The therapist interpreted the client's hallucinatory thought! 
in terms of her attitudes toward her self and her relationship! 
with other people. What would have been the effect oi 
merely reflecting the ideas which she was verbalizing? Whai 
would have been the effect of interpreting her behavior iij 
terms of a transference neurosis? I 

Although the counselor seems to have had a gooc! 
intuitive grasp of the situation and handled it well, ht: 
was so preoccupied, apparently, with questions of "techi 
nique" that he was consciously blinded to the deepei! 
significance of what really transpired. After Joan said,' 

Guilt, Confession, and Expiation 97 

"But I couldn't tell you [and] I couldn't suggest that 
we stop/' his comment is: "It developed that she was 
afraid that that would be rejecting me." Surely something 
far more profound was going on here than any such 
terminology would imply; and it is with precisely this 
Something More that we are here mainly concerned. 


Despite the Biblical exhortation that an honest con- 
fession is good for the soul, there is reason to doubt that 
its benefit is unconditional and necessarily enduring; and 
one wonders how much, in the long run, was really 
accomplished in the episode we have just reviewed. 
Immediately thereafter Joan, to be sure, felt vastly re- 
lieved; but was she ''cured"? What guarantee was there, 
really, that her guilt would be generally assuaged — or, 
indeed, that she would not again resort to the very 
behavior which had already caused her so much inner 
discomfort? The author of the Dick Tracy theory puts 
the problem well by asking in a part of his paper not 
previously quoted: What good does it do to confess your 
past errors to someone who is going to be as secretive 
about them as you have been? This, he goes on to say, is 
not the way for a person to achieve social redefinition 
of personality and true redemption. Just as the offense 
has been against society — that is, against the laws of man 
and God — so, one might argue, the confession and 
Forgiveness (''acceptance") must be as broad as the sin 

Another one of the "critical incidents" collected by 
Standal and Corsini bears quite directly upon this ques- 
l:ion. Here a married woman consults a psychiatrist with 
pomplaints of depression and obsessive thoughts that she 
alight injure her young daughter. After desultory talk 
(during the course of several interviews) had revealed 
[lothing but an exemplary life, the psychiatrist confronted 
che patient, almost roughly, with the logical incongruity 
oetween her symptoms and what she had told him about 
lerself. With great effort, there was then admission of a 
;urprising and particularly degrading perversion; but there 

98 The Crisis in Psychiatry and Religion 

was no dramatic therapeutic gain. In fact, the report ends 
with a comment by the psychiatrist to the effect that the 
patient is ''still in treatment." 

One is therefore prompted to wonder what would hap- 
pen, in situations of this kind, if the confession took a 
more "public" form. Fortunately we have something of 
an answer in a case which has been briefly reported by 
Dr. Anton Boisen (1958). He says: 

The patient in question was a man of thirty-eight years 
who was brought to the hospital in a severely agitated con- 
dition. He thought he had committed the unpardonable sin 
and that something was going to happen to his wife and 
children. He would not, therefore, let them out of his sight. 
He thought a world war was impending and when asked 
what part he was to have in this war, he replied, "A little 
child shall lead them." Obviously, he was the little child. 

The record of his life was that of a well-meaning, friendly, 
likeable person who before his marriage, and even afterward, 
had been sexually promiscuous. What troubled him most was 
an affair with a woman some ten years older than himself, 
clearly a mother substitute. There had been two abortions, 
for which he was responsible. She had died of carcinoma. 
He blamed himself for her death and the disturbance began; 
shortly thereafter. 

The first symptom was heavy drinking. This continued! 
until he lost his job. Following this, he suffered a depression 
and stopped drinking. Then he developed the idea that thej 
Odd Fellows were out to get him because he had violated] 
the oath he took when he joined them. For several monthsi 
he was obsessed with ideas of persecution. He reached 
the point where he went to the police with a request for a! 
permit to carry a gun in order to protect himself from his| 
enemies. He then became finally so disturbed that he con-j 
fessed to his wife, telling her of his sexual transgressions. ! 

This confession she took in good spirit, but in spite of thai] 
fact he became more and more agitated. The idea came 
that something was going to happen to her and that he had 
to carry the weight of the world on his small shoulders 
Commitment then became necessary. In the hospital he 
showed intense anxiety. He was sure of only one thing, that 
things were not what they seemed. He was also deepl} 
aroused religiously. It is not necessary for our purpose tc 
recount his subsequent history beyond reporting that within 
a couple of months he made an excellent recovery and now.; 
after nearly thirty years, there has been no further trouble* 


Guilt, Confession, and Expiation 99 

He is at present a successful contractor and his family is 
prosperous and happy. 

After noting that this man*s guilt was real and grievous, 
Boisen then asks: 

Why now the increased agitation following the confession 
to his wife? Such a question is in order. The answer is clear. 
The emotional disturbance was not the result but the pre- 
condition of the confession. In his normal state of mind 
confession would have been impossible. But the profound 
emotion forced the confession, just as nature's heahng power 
produces a boil or an abscess and then lets the poison matter 
out. In this case, as in others of the type, the disturbance 
brought about a certain degree of socialization. It got rid 
of pretense and hypocrisy and put the sufferer in position 
to be accepted for what he really was. And if it took some 
time for this powerful emotion to subside, that is hardly to 
be wondered at" (pp. 5-6, italics added). 

All this is eminently reasonable, but does it not over- 
look another possibility? Voluntary confession of a legal 
crime may soften the ensuing punishment, but it does 
not abrogate it. So, may we not assume that confession 
of an immorality likewise does not end the matter? In 
Dr. Boisen's case I conjecture that the period of hos- 
pitalization was dynamically necessitated by the confes- 
sion. This man, probably with human beings generally 
in like situations, felt that accounts could not be righted 
until he had, as we often say, ''taken his medicine" and 
paid for his past misdeeds. Can it be that we do not 
properly perceive this function of the mental hospital and 
I hospitalization? 

i Does mere confession of a legal crime absolve one from 
'all further responsibility or punishment? Suppose that 
jlO years ago I committed a murder and was never 
[caught or even suspected. But as time passes, my own 
knowledge of the act becomes increasingly oppressive 
and I finally go to the local police and say: "You remem- 
ber a man by the name of Joe Smith who was mys- 
iteriously murdered a few years ago. Well, I thought you 
might just like to know that I killed him." What would 
then happen? Would the police say, "How very inter- 
esting! We often wondered what happened to that fel- 

100 The Crisis in Psychiatry and Religion 

low. Drop in again sometime." Obviously not! I would 
be taken into custody, would have to stand trial, and, if 
formally convicted, would be sentenced to what was 
deemed appropriate punishment. 

Now is the moral law less demanding than the civil 
and criminal codes? Does conscience have less rectitude 
than a court? Unless we can answer this question affirma- 
tively, it follows that in the moral realm, no less than in 
law, confession is not enough and must be accompanied 
by restitution. This possibility has been generally neg- 
lected in our time and may account for widespread con- 
fusion and misdirected therapeutic and redemptive effort. 
Psychologists and psychiatrists have stressed the impor- 
tance of "insight" rather than personal guilt and repent- 
ence; and even the church has preached what Dietrich 
Bonhoeffer (1948) has called the doctrine of "cheap 
grace," which he holds is no grace at all [see Chapter 11]. 

So can it be that, lacking formal (institutional) recog- 
nition of the need for atonement following sin, modern 
men and women commonly make use, unconsciously, of 
the stigma, disgrace, and suffering connected with being 
"crazy" and hospitalized? Dr. Boisen (1936) has referred 
to the insane as the self-condemned; and to this we might 
add that they are also the self -punished. Depression is 
manifestly a form of self-inflicted suffering; and it has 
often been suspected that the reason why electro-convul- 
sive shock "treatment" may speed the recovery of de- 
pressed persons is that it aids the work of expiation. Cer- 
tainly it is not uninstructive that even untreated depres- 
sion tends to "run its course," that the prospect of 
recovery from any one "attack" is always good but that 
recurrences are statistically likely (hence the diagnosis 
of "cyclothymia"). Therefore, a depression looks very 
much like an act of "serving time," comparable to what 
happens in those other places of penance (or peniten- 
tiaries) where legally convicted offenders are sent. In 
both instances, when one has "paid his debt to society," 
he is again free (of prison in the one case, of depression 
in the other); and the question of whether an individual 
will have one or more later depressions or will be "cured" 
depends (in much the same way as does the reformatory 
action of prison) upon whether he has really "connected" 
crime and punishment. 


Guilt, Confession, and Expiation 101 

But what of schizophrenia? Here the likehhood of 
"spontaneous remission" (getting "out," being "free") is 
not nearly so great; and many students of the problem 
have been led to suspect a deeper malignancy here — 
tainted heredity, disordered metabolism, or the like. Can 
it be that Tim Wilkins is right, that schizophrenia is no 
less a moral disorder than is depression but that in the 
one case the individual is still running, hiding, denying, 
whereas in the other the individual at least unconsciously 
admits his wrong and accepts the justice of suffering? 
In the Boisen case — which had such a favorable outcome 
— we have an individual who showed an admixture of 
depressive and schizoid reactions; and apparently much 
depends, with respect to recovery, upon whether one or 
the other gains the ascendancy. As Dr. Boisen has else- 
where (1936) pointed out, those persons who react to 
personality crisis by becoming resentful and bitter and 
who blame others rather than themselves are well on the 
way to a permanently paranoid adjustment, with a very 
poor prognosis. But when the individual can blame him- 
self and see his predicament as one for which he is largely 
responsible and which he can do something toward 
changing, the prospects of recovery — and personal trans- 
formation — are much brighter [see Chapter 13]. 

Toward which of these courses is would-be therapeutic 
endeavor usually directed? How often we have tried to 
get the neurotic or psychotic (sinful?) individual to see 
his difficulties as stemming from sources outside his own 
ego or self — from a too strict superego, from unreason- 
able, tyrannical parents, or from a "sick society"! And 
how often we have perhaps thus unwittingly pushed the 
individual in the very direction that leads to destruction 
rather than salvation! 

At mid-twentieth century, perhaps secular psycho- 
therapy has already rediscovered one ancient religious 
truth and is on the verge of discovering another. Perhaps 
one of the reasons why classical psychoanalysis, with its 
cardinal emphasis upon "free association," so often makes 
a painful and productive start and then tails off into 
years of dull and unprofitable talk is that it does not help 
the analysand move from free association (confession) 
on to atonement, except to the extent that the financial 
sacrifice which analysis usually entails provides it in at 

102 The Crisis in Psychiatry and Religion 

least temporary or ''symptomatic" form. Perhaps the 
next half century will be well spent if we do nothing 
more than learn how, once again, to make use of mean- 
ingful and effective restitution as a regular and expected 
concomitant of confession (cf. the book of Leviticus in 
the Old Testament). Perhaps there are both individually 
and socially more constructive forms of self-punishment 
and atonement than incarceration in a mental hospital.^ 

* Since the above was written, the author has learned of a 
book now in preparation, under the editorship of Dr. Albert 
Eglash, which will bear the title, Creative Restitution: Guidance 
and Rehabilitation of Offenders. Although concerned mainly with 
the reclamation of legally defined criminals, this book may have 
important implications for the mentally ill as well — if they, 
too, are "offenders." The fact that, in the case of criminals, 
confession or at least "conviction" has already occurred might 
seem to make the total task of rehabilitation easier here than 
with the mentally ill; but, being scZf-condemned, the latter 
may, for this reason, have potentialities which at least the 
criminal psychopath is commonly supposed to lack. Also, as an 
emendation to what has been said in this paper, it should be 
added that there is no intimation here that the particular 
"crimes" to which the mentally ill confess have necessarily 
occurred. As Tim Wilkins observes (in a part of his paper 
which is not reproduced here), a trivial or even nonexistent 
act may be reported and stressed to "cover" the real misdeed 
(cf. Stafford, 1950; Mowrer, 1953; Fliess, 1957). Some psy- 
chiatrists are of the opinion that it is a mistake to encourage 
(or even permit) a psychotic individual to talk about the evil 
acts he has committed, on the assumption that even though 
he may start with valid reports he will soon progress to imagi- 
nary "crimes" and thus become increasingly delusional and dis- 
oriented. Two considerations are pertinent here: (a) If a 
therapist took the patient's first report of wrong-doing seriously 
and immediately started thinking with the patient about a plan 
of restitution (instead of dismissing it as unimportant), perhaps 
the patient would not need to compound his real sins with 
fabricated ones; and (b) if a patient starts with a fabrication, 
might it not be profitable to suggest that he try to return to 
a less dramatic but more tangible and real action that may 
have generated guilt? 


Psychotherapy and the Problem 

of Values in Historical Perspective 


The Devil and Psychopathology* 


One of the reasons for caution in accepting the hy- 
pothesis that mental illness has a moral basis is the 
ubiquity of the contrary view, that it is indeed an illness 
and unrelated to anything for which the individual so 
afflicted might be held accountable. Either the illness in- 
terpretation is essentially sound or else, if erroneous, it 
must be examined and explained as one of those remark- 
able anomalies of which the history of culture is not, 
alas, without precedent. Here we extend the effort al- 
ready begun, in Chapter 6, to plumb the historical depths 
of the problem and in this way, hopefully, discover cir- 
cumstances which will shed new and much-needed light 
on certain present-day perplexities. 

This inquiry also brings us back, once again, to the 
question of the nature of The Unconscious; and on the 
surmise that it is benevolent, rather than evil (as Freud- 
ian theory would have it), the possibility opens up for a 
new synthesis of depth psychology and religion: namely, 
that The Unconscious, thus reconceived, is akin to what 
has otherwise been known as The Holy Spirit. This per- 
ception of the situation is congruent with and a develop- 
ment of the general position adumbrated in Chapter 2. 
Such a re-evaluation and re-interpretation of The Un- 
conscious may go far, not only to achieve such a rap- 
prochement, but also to dispell the pessimism and im- 
potence which have long beset the whole domain of 

* Initially prepared for a symposium on "Psychotherapy and 
Values" held at Ohio State University, May 28-29, 1959, this 
paper was also presented at the University of Minnesota, April 
16, under the auspices of the Department of Psychology, and 
later served as the second of the 1960 Earl Lectures, on 
"Psychoanalysis and the Judeo-Christian Ethic." 


104 The Crisis in Psychiatry and Religion 

In a related paper [Chapter 8] the writer has suggested 
that we have seriously erred in interpreting guilt, clini- 
cally, as mere gm\t feeling rather than as a reality-based 
state stemming from palpable, incontestable misconduct. 
In support of this view, a paper entitled *'A New Theory 
of Schizophrenia" by an anonymous author (1958) is 
cited in which the position is taken that schizophrenia is 
typically a condition in which a person is driven by a sort 
of progressive terror lest his sins find him out. Then, in 
an account of a dramatic interview with a young woman 
known as Joan (Standal & Corsini, 1959), we see how 
great the pressure may be, in some schizoid individuals, 
to disclose their misconduct and thus, hopefully, find 
peace and reconciliation. But confession, as we know, 
may bring transitory relief without, however, effecting 
a permanent cure. This consideration is exemplified in a 
case history recently published by Boisen (1958), in 
which a man becomes emotionally disturbed and con- 
fesses infidelity and other serious breaches of morality to 
his wife; but, far from finding an honest confession good 
for his soul, this man becomes even more disturbed and 
has to be hospitalized. Boisen's interpretation of this 
course of events goes as follows. 

The emotional disturbance was not the result but the 
precondition of the confession. In his normal state of mind 
confession would have been impossible. But the profound 
emotion forced the confession, just as nature's healing power 
produces a boil or an abscess and then lets the poison matter 
out. . . . And if it took some time for this powerful 
emotion to subside, that is hardly to be wondered at 
(pp. 5-6). 

In other words, the view here set forth by Boisen is 
that by the time an internal crisis reaches a point where 
it is powerful enough to prompt a confession, it may have 
gained so much momentum that it "carries" the person 
past the functional objective, which is confession and the 
attainment of openness. In the paper first cited, I have 
suggested the alternative possibility that disturbance 
often continues beyond the point of confession (and thus 
makes confession seem useless and even harmful) for 
the reason that confession is not, of itself, dynamically 
sufficient and must, in many instances, be accompanied 


Psychotherapy and the Problem of Values 105 

by some form of atonement or expiation. Where this de- 
mand is consciously recognized, the individual may make 
a profound resolution or "vow" v^hich will alter the en- 
tire course of his life and thus ''save" him; but where 
the needs of the situation are not so well understood, it 
is as if the unconscious forces drive the individual into 
manifest insanity (and hospitalization — or worse) as the 
punishment, suffering, and humiliaton he must endure 
before he can again (if ever) comfortably face himself 
md others. 

If, in the neurotic or psychotic individual, guilt is real 
rather than fancied, the whole logic and strategy of 
secular psychotherapy has to be reconsidered. I say if the 
^uilt is real. This is a question of fact which has been 
mswered to my own satisfaction but is, of course, open 
to further investigation by others. However, granting 
that the psychoneurotic individual is responsibly guilty 
md not just a victim of false scruples, an even more 
3asic question arises as to why Western civilization ever 
:ame to doubt or deny the relationship between guilt, 
^eal guilt, and psychopathology. This question can, I 
relieve, be answered only in the light of certain broad 
listorical developments, which we shall explore in the 
pages that follow. 


Prior to the Protestant Reformation, no one (relatively 
jpeaking) doubted the reality of guilt. It did not matter 
ivhether you felt guilty or not; if you had acted in cer- 
tain ways, done certain things, you took it for granted 
that you must confess and obtain forgiveness. Otherwise, 
i^our soul was in mortal danger. 

Martin Luther and the other Reformers, of course, 
changed all this. There had, it seems, been widespread 
ibuses and corruption, of a kind not without historical 
precedent. For some time prior to the Reformation, re- 
demption from guilt required not only that the individual 
:onfess and do ordinary penance but that, in addition, he 
buy special "indulgences," for himself and also for others 
3ear to him who might now or at some future time be 
in Purgatory (Bainton, 1950). Here one can hardly 

106 The Crisis in Psychiatry and Religion 

escape being reminded of the scene in the Temple where 
Christ scourged the moneychangers for their traffic in 
forgiveness. This outburst, probably more than any other 
single act or combination of acts in the life of Christ, 
turned the entrenched forces of orthodox Judaism against 
him and led to his execution. Only by the most improb- 
able combination of circumstances did Luther survive 
the fury which his criticisms and insubordination re- 
leased; and if one holds that the revolution which fol- 
lowed was less momentous than the Christian "reforma- 
tion/' who can say what would have happened if Luther, 
too, had been martyred? 

As the Protestant Reformation became consolidated, 
it was, of course, inevitable that sweeping changes would 
be instigated with respect to confession and penance. 
Milder changes were readily imaginable; but both prac- 
tices were, in effect, abolished. Grace, it was argued, is 
not dependent upon other men but comes from God 
alone. Therefore, you were to take your case to God, in 
prayer, and ask for his forgiveness directly, without 
priestly intervention. This arrangement was regarded 
as a great stroke of genius. And I can remember my own 
father telling me, as a child, a ''joke" which went as 
follows. For some time a small boy had been given a 
dollar every month and told to go to the priest for con- 
fession. Finally, the boy became curious and asked his 
parents who confessed the priest. The answer was, the 
Bishop. Who then, he asked, confessed the Bishop? The 
Cardinal, came the reply. Who confessed the Cardinal? 
The Pope. And who confessed the Pope? No one con- 
fessed the Pope, the boy's parents told him; he took his 
sins to God. To which the boy, with a flash of inspira- 
tion, exclaimed: ''I think I'll do as the Pope does; I, too, 
will take my sins directly to God and save my dollar!" 

This new provision for a short-cut to God and absolu- 
tion was supposedly a great innovation, liberation, and 
triumph. But history may yet show that it was instead a 
grim and costly error. There can surely be no denying 
that, on the whole. Protestantism has handled the prob- 
lem of guilt very badly. It has left its followers in a state 
which perhaps made them "creative" and "ambitious" 
in a feverish, unhealthy way; but it has also disposed us 

Psychotherapy and the Problem of Values 107 

to the mass neurosis and pervasive anxiety which are so 
much a part of the modem scene.^ 

Gradually Protestantism is recognizing this ambiguity 
in its doctrines and practices and is today in the process 
Df reinstituting confession. If this assertion seems rash, I 
ivould cite the development of ''confession to a Christian 
brother," as advocated by Deitrich Bonhoeffer (1954),. 
in his book. Life Together, and now practiced in the 
Serman Lutheran Church. But, even more pertinently, I 
ivould call attention to the pervasive recourse to "pastoral 
counseling" in this and other countries, which, although 
it has the trappings of secular psychotherapy, is surely 
but a disguised return of the confessional (see especially 
Meehl et al, 1958, pp. 68-69). [See also Chapters 11 
and 12.] 

However, since pastoral counseling has been so largely 
inspired by and patterned upon secular psychotherapy, it 
is not surprising that it, too, has important shortcomings. 
Secular psychotherapy, we must remember, does not really 
beheve in guilt, only guilt feelings (or a "guilt sense"; 
White, 1956); and the aim of the type of "confession"" 
which it encourages, i.e., free association, is "insight"" 
rather than repentance and restitution. Moreover, as 
Bonhoeffer (1948) in his book. The Cost of Disciple- 
shipy argues. Protestantism has itself really abandoned 

^In a footnote Fromm (1955) says: "All figures show that 
Protestant countries have a much higher suicide rate than 
Catholic countries. This may be due to a number of factors 
inherent in the difference between the Catholic and Protestant 
religions, such as the greater influence which the Catholic re- 
ligion has on the life of its adherents, the more adequate means 
to deal with a sense of guilt employed by the Catholic Church, 
etc. But it must also be taken into account that the Protestant 
countries are the ones in which the capitalistic mode of pro- 
duction is developed further, and has molded the character of 
the population more completely than in the Catholic countries,, 
so that the difference between Protestant and Catholic countries 
is also largely the difference between various stages in the 
development of modern Capitahsm" (p. 151). Therefore, the 
little story related above is doubly illuminating: it shows not 
only the reduced capacity of Protestantism for handling in- 
dividual guilt but also its encouragement of thrift and material 

108 The Crisis in Psychiatry and Religiok 

the strategy of confession and atonement in favor oi 

what he calls the doctrine of "cheap grace." 


Cheap grace is the preaching of forgiveness without re* 
quiring repentance, baptism without Church discipline, Com^ 
munion without confession, absolution without contrition. 
Cheap grace is grace without discipleship, grace without the 
Cross, grace without Jesus Christ, living and incarnate. . . 

Costly grace is the gospel which must be sought agaiiJ 
and again, the gift which must be asked for, the door aH 
which a man must knock. \ 

Such grace is costly because it calls us to follow, anq 
it is grace because it calls us to follow Jesus Christ. It 
is costly because it costs a man his life; and it is graai 
because it gives a man the only true life. It is costly be 
cause it condemns sin, and grace because it justifies the sinne; 
(pp. 38-39). 

Most pastoral counseling, as we know it today, there 
fore falls short, as does secular psychotherapy, of th(; 
crucial and ultimate step in the quest for salvation anc 
personal wholeness. If one takes the neurotic's guilt se 
riously, that is, if (as now seems likely) "neurosis" h 
just a medical euphemism for a "state of sin" and socia 
alienation, therapy must obviously go beyond men; 
"counseling," to self-disclosure, not just to a therapist oi 
counselor, but to the "significant others" in one's life 
and then on to active redemption in the sense of th< 
patient's making every effort within his power to undc 
the evil for which he has previously been responsible. ^ 

^The Catholic Church has, of course, always taken guili 
seriously to the extent of holding to the necessity of con 
trition, confession, and satisfaction or penance {Catholu 
Almanac, 1959 p. 277). And so the question is sometime; 
asked. Why are Catholics not more protected than they arf 
from personality disturbance, if the management of guilt anc 
mental health are related? The answer seems to be: (a) 
many Catholics do indeed enjoy unusually good mental health 
(b) some Catholics — and indeed their confessors — are per 
functory about confession and penance, i.e., the punishmeni 
often does not fit the crime, psychologically; and (c) the Cath 
olic Church identifies contrition, confession, and penance as i 
sacrament, whose central aim is other-worldly salvation rathe 
than mental health or adjustment in this life. Therefore, Cathol 
icism provides no clear test, either in practice or in theory, o 
what confession and penance can do in a more naturalistic way 

Psychotherapy and the Problem of Values 109 

At this juncture it is, of course, easy to get involved 
in a tedious theological debate as to whether salvation 
is by "good works" or by "grace alone." For myself, I 
have no desire to argue the point but will merely state 
that I, personally, take my stand with the Apostle James 
and Deitrich Bonhoeffer, against the Apostle Paul and 
Martin Luther, or at least against the extreme interpreta- 
tions sometimes put upon their teachings. Be it granted 
that it ill becomes a man to proclaim his own righteous- 
aess — this, surely, is a judgment for others to render. But 
to assume that grace or redemption or change comes only 
as a result of divine election or selection is, to my way of 
thinking, to cast a hopeless blight on the whole problem 
[see Chapter 11; also Mowrer, 1961]. 

No other therapeutic or "redemptive" movement, 
within the church or without, has in recent times been so 
successful as Alcoholics Anonymous. Here guilt is seen as 
basic and real; and its open admission is regarded as an 
indispensable first step, to be followed by a definite 
program of good works and restitution. Sometimes, when 
the accomplishments of Alcoholics Anonymous are al- 
luded to, it is asked: But why was the Oxford Group not 
also a success? Up to a point the Oxford Group was a 
success (see Glark, 1951); and that point was that it 
encouraged confession and openness but had no provi- 
sion for taking its members on from there. If it did noth- 
ing more, the movement deserves credit for having in- 
spired the formation of AA, where the weakness of pure 
Buchmanism is offset by a clearly specified program of 
"missions" and mercy. 

The trial which AA has blazed is the only one down 
iwhich I can at present gaze and see anything that looks 
'like the road to the future. How AA principles can be 
jadapted or modified to meet the needs of other kinds of 
|:;onfused and suffering people is not fully clear to me. 
IBut I am as sure as I can be of anything that no therapy 
[will be radically and broadly successful which does not 
itake the neurotic's guilt seriously and does not help him 

For a quite remarkable, and unusual, attempt to deal with the 
laturalistic (psychological) implications of confession in the 
"Catholic context, see Wilson (1954) [see also Chapters 11 

id 12]. 

110 The Crisis in Psychiatry and Religion 

admit his errors openly and find ways to work in dead 
earnest to rectify and compensate for them. 

As an active churchman, I beheve that the concept o£ 
God is vital and meaningful and that the so-called 'Verti- 
cal dimension/' between God and man, is vital and mean- 
ingful; but I do not believe that this relationship can be 
either vital or meaningful if it is not complemented and, 
indeed, often preceded by serious concern on the part of 
the individual with the horizontal dimension, namely, 
the relation of man to man. The total situation has welli 
been termed ''triangular," with God, the individual, and 
one's fellowmen at the three corners. The nature of the 
relationship is also well described by the following lines: 

I sought my soul and sought My God, 
But neither could I see; 
And then I sought my neighbor, 
And then I found all three. 

Intrepid and bold as the Protestant Reformation un- 
doubtedly was in many ways, one can hardly avoid the 
judgment, at this vantage point in history, that it was 
also crucially incomplete (cf. Section VI; also Tillich, 
1948). If, for the third time in the past two thousand 
years, there is again widespread mercenary traffic in for- 
giveness, perhaps this scandal, no less than the former 
ones, will prompt changes of a radical and "redemp- 
tive" kind. 


In his Autobiography, Freud (1935) — writing with his 
usual plausibility and charm — speaks of the circum- 
stances, both personal and cultural, which prompted the 
development of that remarkable body of theory and prac- 
tice which was to be known as psychoanalysis. By the 
end of the 19th Century, the church, as we have seen, 
had largely abandoned its interest and claim to com- 
petence in the area of psychopathology; and medicine 
had an essentially organic conception of the problem, 
with the result that there were, as Freud observed 
"crowds of neurotics, whose numbers seemed further mul- 
tiplied by the manner in which they hurried, with their 

Psychotherapy and the Problem of Values 111 

troubles unsolved, from one physician to another" (p. 


Being a Jew in a nominally Christian country, Freud 
experienced one disappointment and frustration after an- 
other in his original hope of securing an academic posi- 
tion; and finding himself thus, as he said, ''forced into 
the Opposition" (p. 24), the outcast Jewish doctor 
eventually began, understandably enough, to direct his 
professional attention to what we may also call the "out- 
casts" among patients. The superabundance of neurotic 
individuals who were seeking Something and not finding 
it and the accident of Freud's finding himself now aligned 
with "the Opposition" provided the sour soil in which 
psychoanalysis germinated and began its growth. "My 
therapeutic arsenal [in the beginning]," Freud said, "con- 
tained only two weapons, electrotherapy and hypnotism, 
for prescribing a visit to a hydropathic establishment 
after a single consultation was an inadequate source of 
income" (p. 25). And when, at length, Freud became 
disgusted with both electrotherapy and hypnotism, he 
simply began listening to his patient talk. From this 
seemingly inauspicious beginning came the now well- 
known analytic technique. 

As we shall presently see, the solution which Freud 
ultimately offered to the emotionally, morally, and 
spiritually troubled person is very far from a religious 
solution; and we are now beginning to supect that it is 
also very far from a soundly scientific one. Yet the fact is 
that Freud, and the disciples whom he soon attracted, at 
least walked in the Valley of the Shadow with these un- 
I happy, distraught individuals, in a way which neither the 
ordinary physician nor the typical clergyman of the time 
had been willing to do. Surely it is not without deep 
significance that a theologian recently remarked: "Re- 
gardless of whether Freud was right or wrong in his 
theory, he at least tried to minister to a class of sufferers 
ion whom the church, Protestant and Catholic alike, had 
I turned its back. This is to our inescapable and enduring 
ishame!" (De Wire, 1958). 

The end of the 19th Century found the Catholic 

Church still licking its wounds from the Reformation 

\ and smarting from the memory of its folly in dealing with 

Galileo. And, in the decades just past, the credibility of 

112 The Crisis in Psychiatry and Religion 

the Church had, of course, been further challenged by 
Darwinian evolution. While Protestantism had perhaps 
not shown the same degree of opposition to science, it 
too was in a precarious state because, among other rea-j 
sons, of its ineffective handling of the problem of guilt. ! 
Therefore, when Freud, in the name of science, began! 
to proclaim discoveries in the realm of mind as revolu-! 
tionary as those of Copernicus and Calileo in astronomy \ 
and of Darwin in biology, there was little religious vitality 
to oppose him. 

Although Freud thus spoke in the name of Science, 
and eschewed all theological considerations, it is no ac- 
cident that he was a Jew and that psychoanalysis, as' 
ideology and as therapy, developed as it did. Having 
suffered repeated rebuffs and disappointments at the 
hands of what he referred to as the ''compact majority," 
Freud had no reason to be anything but gratified by the 
embarrassment and failures of organized religion; and he 
let no opportunity pass for striking at what was not only 
a personal affront but also, as he conceived it, the enemy 
of all mankind (cf. Freud, 1928). Having been excluded, 
or at least so he imagined, from the opportunities and 
privileges which would have perhaps been open to him 
as a Christian, he gave up trying to function within con- 
ventional boundaries and developed what he himself, 
with magnificent understatement, termed "a certain de- 
gree of independence of judgment" (p. 11). 


Just how great was Freud's disaffection from conven- 
tional streams of thought and values becomes clear when 
we discover that not only was he alienated with respect 
to Christianity but also from the main currents of 
Judaism. In a remarkable book by David Bakan (1958a) 
which will be considered more fully in the next section, 
we learn that Freud's family, together with many other 
Viennese Jews, had migrated from Galicia, which, says 
Bakan, "had been saturated with Jewish mysticism" (p. 
80), of the Kabbalistic variety. This sect, or splinter 
group, differed from traditional rabbinical Judaism in a 
number of ways which, as Bakan ingeniously shows, 
strikingly anticipate important and distinguishing features 

Psychotherapy and the Problem of Values 113 

of psychoanalysis. The following excerpts capture some 
of the salient features of Kabbala and suggest a probably 
more than coincidental relationship to psychoanalysis. 

One of the meanings of the word Kabbala is tradition in 
. a way which connotes oral transmission. Another meaning is 
acceptance as the mystics are accepted before God. A third 
meaning of the term is that which is received, suggesting its 
revelatory character. The Kabbala is something referred to 
as the Secret Wisdom to indicate that it is comprehensible 
only to the initiated. . . . 

Kabbala has always had about it an aura of danger, 
perhaps for good reason. In the light of the later psycho- 
analytic developments, this danger may be best understood 
as that associated with bringing repressed material into con- 
sciousness (p. 70). 

Recalling our earlier discussion of the friendship between 
Freud and Fliess, Kabbalistic tradition provides a further 
hint concerning the nature of the relationship. In his psycho- 
analytic work, which we maintain is Kabbalistic, Freud 
needed an "associate," because the burden of the Kab- 
balistic thought is too difficult for anyone to bear in inde- 
pendent study. . . . 

The tradition is one pervaded by a sense of secrecy. . . . 
The Kabbalists were endowed with mystery and power 
(p. 71). 

As will become increasingly evident in what follows, a 
theory of repression and the role of the ego in repression 
are already germinal here. Abulafia [a 13th-Century Spanish 
Kabbalist] has essentially two methods of meditation in order 
to achieve the desired release of the soul. The first of these 
is an interpretative method based on taking liberties with 
the letters of the alphabet (p. 76). 

The second important method for which the first is but 
a preparation is called "jumping and skipping" [which Bakan 
identifies as a forerunner of the method of free association] 
(p. 77). 

Associated with such meditation is an intellectual ecstasy 
identifiable with psychoanalytic insight (p. 79). 

Furthermore, Abulafia regards the Kabbalistic teacher as 
extremely important, a harbinger of the idea of the trans- 
ference (p. 80). 

That Freud would have had contact with Kabbalistic 
thought and practice is insured by the circumstances al- 
ready cited, to which can also be added the fact that dur- 

114 The Crisis in Psychiatry and Religion 

ing the latter half of the 19th Century Adolf Jellinek, 
who was a close student of Kabbala, was, Bakan reports, 
"the most popular Jewish preacher in the city of Vienna 
in his day. It is said that when Jellinek spoke on the week 
end the Jews of Vienna would discuss what he said for 
the whole succeeding week" (p. 81). 

Hence we arrive at the conclusion that Freud not only 
stood apart from Christianity but that he had little af- 
finity even for orthodox Judaism. He was, however, very 
probably influenced, consciously or unconsciously, by a 
singular and indeed somewhat sinister variety of Jewish 
mysticism. In his expressed allegiance to science and in 
yet other ways, Freud revealed also a sympathy with and 
admiration for classical Greek culture, a fact which is 
well known. But the knowledge of his affiliation with 
Kabbalism, as brought out by Bakan, is new and puts 
psychoanalysis into a surprising context, which will be 
further considered in the next section. 

IV. did FREUD ''play THE DEVIl"? 

It is remarkable how slow we sometimes are to perceive 
realities which we do not expect, or wish, to be true. It | 
is more than thirty years now since the writer first he-\ 
came interested in psychoanalysis and resorted to it, as a i 
form of psychotherapy and, hopefully, also as a new way 
of life. For the better part of two decades he tried to 
make it ''work" but to no avail; and so, little by little, 
he became critical of psychoanalysis and returned to 
more conventional views and values. And this experience 
is today by no means uncommon. Yet it is with a real 
sense of surprise and even shock that one reads the evi- 
dence which Bakan, in his book Freud and the Jewish 
Mystical Tradition (1958a), has assembled for believing 
that Freud not only repudiated Mosaic and Christian 
conceptions of God but, in addition, identified himself 
with the Devil. 

That Freud, as Bakan maintains, felt himself in mortal 
conflict with Moses, the Law Giver, is not, of itself, sur- 
prising. Perhaps the most basic tenet of psychoanalysis is 
that neurosis is due to too great severity of the superego; 
and Freud may be said to have "invented" psychoanalysis . 
for the avowed purpose of combatting conscience, the 

Psychotherapy and the Problem of Values 115 

superego, the Law, and, by implication, the Law Giver. 
Then, reasons Bakan (1958b): 

If Freud conceives of himself as the new Lawgiver, . . . 
he must at one and the same time be like unto Moses, the 
previous Lawgiver, whose place he must preempt, and must 
be destructive of Moses. The new Lawgiver must revoke 
the older Law. The identification with Moses turns into its 
opposite, the destruction of Moses" (pp. 323-24). 

The Talmud and the other Rabbinical writings constitute 
an elaboration of dicta of the Mosaic code, which the Ortho- 
dox Jew takes upon himself to guide his life at every moment 
and in connection with every action. In a word, Moses is 
representative of the superego, the force generated within 
the individual to keep him from "instinctual gratification." 
The force which maintains renunciation of instinctual gratifi- 
cation is the fear of punishment. In the allegory of the 
discussion of a statue [of Moses, by Michelangelo] Freud 
is saying that the feared punishment will never eventuate. 
The superego is restrained (p. 324). 

Freud's repeated affirmation of his Jewish identity becomes 
illuminated through Moses and Monotheism. If it is the 
Jew who carries the burden of the historical superego, then 
it is only a Jew who can really remove the sense of sin. We 
recall in this connection Freud's assertion that psycho- 
analysis could only have been created by a Jew; in a letter 
to his Swiss friend Oskar Pfister he wrote, ". . . by the 
way, how comes it that none of the godly ever devised 
psychoanalysis and that one had to wait for a godless Jew?" 
If the Jews represent the authority of the Law, only a Jew 
can declare that the Law is dead. Psychoanalysis, in this 
larger cultural sense, may be viewed as a fundamental effort 
to modify the classical image of the Jew. . . . Thus Freud 
plays the role of a new Moses who comes down with a new 
Law dedicated to personal psychological liberty (p. 329). 

For Freud and psychoanalysis the task of treating 
neurotic individuals thus became at one with the libera- 
tion of mankind from the Mosaic Law, a task which 
pakan (1958a) characterizes as ''Messianic." He says: 

One of the critical features of Messianism is its goal of 
leading people out of slavery and oppression. Thus Freud's 
whole effort at the creation of psychoanalysis may be viewed 
as Messianic in this respect (p. 170). 

But since the oppressor was none other than the 
mighty Moses and since his traditional adversary was the 

116 The Crisis in Psychiatry and Religion 

Devil himself, it is logical — though none the less astonish- 
ing — that Freud should have consciously identified him- 
self with the Devil. At the end of Chapter 22 Bakan i 
quotes Freud as having once remarked to colleagues: 

Do you not know that I am the Devil? All my life I have 
had to play the Devil, in order that others would be able to 
build the most beautiful cathedrals with the materials that 
I produced (p. 181). 

There then follow the five chapters which comprise 
Part IV of the Bakan book, entitled 'The Devil as Sus- 
pended Superego." In 1923 Freud published a remark- 
able paper on "A Neurosis of Demoniacal Possession in 
the Seventeenth Century," in which he relates the story 
of the painter Christoph Haitzmann, who in a period of 
discouragement and depression had contracted with the 
Devil to be his, body and soul, at the end of nine years 
in return for success in his art and surcease from sadness. 
As the time approached for the contract to be consum- 
mated, Haitzmann became increasingly agitated (show- 
ing symptoms which would today probably be regarded 
as schizophrenic — see Macalpine & Hunter, 1956) and 
successfully sought priestly intervention and protection. 

In Freud and the Jewish Mystical Tradition, Bakan 
develops and convincingly documents the thesis that, at 
least metaphorically, Freud himself had, some twenty- 
five years earlier, entered into a "Satanic Pact" and that 
psychoanalysis was the result thereof. For a period prior 
to the publication of Die Traumbeutiing in 1900 (which 
he always regarded as his masterpiece), Freud had been 
in a state of unproductivity, discouragement, and depres- 
sion (as is now known from the Fliess correspondence; 
see Bakan, 1958a, p. 221 and p. 224). But then some 
sort of personal change or rearrangement of his emotions 
and mental powers took place; and we get more than a 
hint of what this change was from the motto in Latin 
which appears on the title page of this book. The quota- 
tion is taken from a passage of Virgil's Aeneid and, when 
translated in its entirety, reads: 

Well, if my powers are not great enough, I shall not 
hesitate — that is sure — to ask help wherever help may be 
found. If the gods above are no use to me, then I'll move 
all hell. I 

Psychotherapy and the Problem of Values 117 
And here Bakan comments, insightfully: 

If God is identified with the superego, then the corre- 
sponding antagonistic image is the Devil, who dwells iii 
hell. As we have indicated earlier, in the psychoanalytic 
relationship the analyst is at one and the same time the 
representative of the superego as well as a tolerant, under- 
standing father figure. Now what is the Devil, psychologi- 
cally? The answer is eminently simple, on one level. The 
Devil is the suspended superego. He is the permissive super- 
ego. The Devil is that part of the person which permits him 
to violate the precepts of the superego (p. 211). 

In summarizing Chapter 27, Bakan says: 

In our discussion of hypnosis, cocaine, and the transference, 
indications of suspension of the superego were suggested. 
Our introduction of the Devil idea into this discussion rounds 
out the great drama which was taking place in Freud's mind 
in his creation of psychoanalysis . . . (pp. 212-213). 

And finally, toward the end of Chapter 30, we read: 

The Devil is then a cure for despair. He is called upon 
as an assertive act when all hope is gone. And in this sense 
also, the Devil is always the Tempter. The essential message 
of the Tempter is that the anticipated rewards associated 
i with resistance to temptation will not be forthcoming, that 
j faith is groundless. The Devil presents the new hope, and 
supports this promise by immediate tokens of his favor. 
But since these tokens themselves bring so much relief, one 
permits oneself, in his relationship to the Devil, to be thus 
taken in (by the Devil), since he feels that he has already 
been taken in (by God). 

In more secular terms, Freud suffered from acute depres- 
sions. His self-analysis, and his development of psychoanalysis, 
were the cure for his depression. His practice had already 
provided him with ample evidence that diseases which other 
people were suffering from, for which there was no other 
hope, could be cured by such means. In his despair over 
making a living, and in his despair over anti-Semitism, he 
had 'little or nothing to lose" by his "audacity." Further- 
more, this new set of methods which he was producing held 
out the promise of bringing patients to him and so solving 
at least the problem of making a living (p. 236). 

Thus does Bakan develop and document his conten- 
tion that Freud, at least metaphorically, "played the 
Devil" — ^but that he did so in a good cause. However, as 

118 The Crisis in Psychiatry and Religion 

we know, "playing the Devil" also carries the implication 
of eventually causing disaster! It is this aspect of the 
situation to which we now turn our attention. 



Today no one, of course, "believes" in the Devil in 
the sense in which he was conceived in the Middle Ages. 
Instead, we have come to "believe" in Freud and psy- 
choanalysis. But now we are confronted by the astonish- 
ing possibility that Freud and his works are the 20th- 
century equivalent of the Devil, thinly disguised. And 
this possibility is rendered all the more palpable by the 
fact that Bakan, who has so vividly brought this pos- 
sibility to our attention, is himself an admirer and de- 
fender of Freud. The logic by which Bakan reconciles 
this apparent contradiction and justifies his "audacity" 
cannot be reproduced here, partly because it is intricate 
and partly because I am not sure I fully understand it. 
But we can and should note one or two additional bits 
of evidence which Bakan (1958a) adduces in support of 
his remarkable thesis: 

The question of the seriousness of Freud's entry into the 
Satanic Pact may well be raised. Freud was a modern man 
who did not believe in supernatural beings (p. 215). 

Perhaps precisely because Freud did not accept the super- 
natural reality of the Devil, he could permit himself the 
full exploitation of the metaphor. We may imagine that 
at times the sense of possession became quite strong; and 
it is this feeling of possession that Freud is analyzing in his 
paper [ostensibly dealing with the 17th-Century painter, 
Christoph Haitzmann] (219). 

"According to Bakan, both Freud and Haitzmann had 
sought the help of the Devil in their struggle against 
depression, which is a work of the superego. Therefore, 
metaphorically at least, the powers of the Devil might 
be thought of as generally useful in the campaign against 
the superego, a campaign which is supposed by psycho- 
analysis to be so essential to the treatment of all neurosis. 
Says Bakan: 

Throughout the Middle Ages the Devil was a star in the 
great spiritual drama which was then taking place. As Freud 


had so aptly pointed out, even though the Devil is perhaps 
no longer a personage in the same sense as in the Middle 
Ages, the psychological phenomena associated with his image 
are still current and important. We have already indicated 
the psychological significance of the Devil image as an ally 
against the superego, or better, as its suspension (p. 231). 

More prosaically this can be stated as follows: The disease 
of the neurotic is his guilt. This guilt is, in itself, an evil 
and its removal is good. ... If God is the guilt-producing 
image, then the Devil is the counterforce. . . . 

As Freud said in discussing Anatole France's Revolt of 
the Angels, "War will produce war and victory defeat. God 
defeated becomes Satan and Satan victorious will become 
God" (p. 233). 

But enough of conjecture and finely spun inferences! 
Vhat, in actual practice, is the strategy and goal of psy- 
hoanalysis? Analysts have been a little hesitant about 
mblishing verbatim accounts of what, in fact, transpires 
n analysis. And when, on occasion, this reluctance has 
)een overcome and verbatim transcripts have appeared, 
me understands why analysis, like a Witches' Sabbath, 
)rospers best in an atmosphere of secrecy and darkness. 
7he following excerpts, quoted by de Grazia (1952) 
rom a psychoanalytic transcription, illustrate the point: 

patient: Not only is there this fear of being in an intimate 
relationship with a woman, but I am also obsessed with the 
fear concerning that blasphemous thought. The reason for 
this seems to be that I had sold myself to the devil, merely 
by thinking this thought to myself. It is a fear of being 
possessed by the devil. I know it is rather absurd and based 
on the ol<3 theology. The devil seems to represent all that is 
evil or bad. 

The fear of selling myself to the devil takes my thoughts 
back to a dream I had at the age of 5 or 6 years. I was 
sleeping with my mother at the time. I woke up trembling 
very violently. I thought I saw a phantom fly across the 
room. It was like a flame, and yet it was like an imp grinning 
i at me. It flew across the room and out of the window. I was 
scared to death. 

therapist: What is the flame you would get if you were 
sleeping with your mother? 

patient: Love of my mother, I suppose. 

therapist: What is the flame you would get if you were 
sleeping with a young lady? 

patient: Passion^ 

120 The Crisis in Psychiatry and Religion 

therapist: Would you? 

patient: No, I expect I should be scared to death, and 
trembling violently, like I was in the dream. 

. . . Now my main concern is this idea or obsession that 
I am possessed by the devil. 

therapist: Suppose you are? 

patient: That would mean that one would lose control 
of one's will. 

therapist: What is natural? 

patient: Do you mean that what I am afraid of is my 
own natural urge to live a normal natural life . . . ? 

And during the next session: 

patient: Perhaps I am scared of a girl because I am 
terrified that my sexual feelings might run away with me, 
and I might not act rationally. 

therapist: What might you do? 

patient: I might love her too much. 

therapist: What would that lead to? 

patient: My desire would be to put my arms around her, 
and tell her I love her. But I was scared. 

therapist: Does that seem so terrifying? 

patient: Well, I might have sexual intercourse with her: 
that would be going too far. 

therapist: Would it? 

patient: Well, perhaps not as far as sexual intercourse. 
If that is the devil, perhaps he is quite a harmless devil. 
Perhaps the sooner I went to the devil the better. 

therapist: If that is all there is to it, why is there all 
this scare? 

patient: Apparently all this time I have been afraid of 
being possessed by my own nature. The thing I want more 
than anything else is to lead a normal natural life. Since 
coming to you I have understood that this fear of being 
sold to the devil is nothing more or less than fear of my 
own nature on the one hand, and on the other hand a 
preference for it, which I have thought was a preference for 
the devil. 

The whole amazing thing has become quite plain to me. 
It is amazing how the obsession left me last night after that 
talk with you (pp. 100-102) [cf. Berg, 1948, pp. 78-80]. 

A playwrite could not have produced a better script 
for a modern re-enactment of the temptation and fall of 
man as it supposedly occurred in the Garden of Eden. 
Here Adam and Eve were attracted by the possibility of 

Psychotherapy and the Problem of Values 121 

sating of the fruit of the Tree of Knowledge but were 
restrained by God's contrary commandment (superego). 
But, step by step, the Devil showed them how pleasant, 
natural, and harmless eating the fruit would be. The 
Devil succeeded, and Adam and Eve were "cured" of 
their apple-eating inhibition. But the cure ultimately 
proved, of course, to be worse than the "disease"; and 
this seems also to hold for the fruits of psychoanalvsis. 
[n one of the last papers he ever wrote, Freud (1937) 
looked back upon the therapeutic accomplishments of 
psychoanalysis and did not find them reassuring. Typi- 
cally, Freud said, patients give the appearance of making 
a good recovery and leave analysis; but then, sooner or 
later, they are likely to experience a recurrence of their 
old difficulties or the outbreak of new ones. 

In studying various developments and changes we focus 
our attention entirely on the result and we readily overlook 
the fact that such processes are usually more or less incom- 
plete, that is to say, the changes that take place are really 
only partial. A shrewd satirist of the old Austria, Johann 
Nestroy,. once said: "Every advance is only half as great as 
it looks at first." One is tempted to think that this malicious 
dictum is universally valid (p. 330). 

J And two decades later, an eminent American analyst 
;(Kubie, 1956) was prompted to confess: 

In this connection I recall Edward Glover's statement 
[personal communication] that analysts sometimes seem to 
achieve their greatest successes when they are beginners. Even 
if Glover's statement was in part an ironic and rueful jest, 
it indicates a mood of healthy reserve about our right to 
claim therapeutic omnipotence or omniscience. . . . My own 
observations of analytic defeats have convinced me that 
basic gaps remain in our knowledge of the dynamic processes 
both of illness and of therapy. . . . 

Only a few years ago (although it seems a long time in 
my life as an analyst) I harbored the comforting expectation 
that increasing analytic sophistication and experience would 
yield a higher percentage of therapeutic successes. . . . My 
reluctant impression is that this hope has not been realized 
(p. 87). 

From testimony now available from both the friends 
ind the foes of analysis, it is clear that, at best, analysis 
iasts a spell but does not cure. By aligning himself with 

122 The Crisis in Psychiatry and Religion 

the patient's id, the analyst ( "Devil"? ) may indeed suc- 
ceed, as Bakan puts it, in suspending the superego; but 
the superego (or conscience), more commonly than we 
might wish to believe, is a reflection of enduring social 
realities; and the advantage we gain by overcoming it in 
analysis is dearly paid for later, many times over. Man's 
salvation must surely come, not from his looking and 
moving downward, but from an upward reach, toward 
reconciliation and community, made by means of confes- 
sion and manifest restitution. 


Even though Freud today stands indicted of having 
"played the Devil," there are many modern-minded men 
and women who will not greatly blame him. By theii 
narrowness, bigotry, arrogance, sanctimony, false piety, 
irrealism, supernaturalism, and hypocrisy, several genera- 
tions of theologians and laymen have given organized' 
religion an exceedingly negative imprint and reputation;! 
and if there have been those who said, "Let the Devilj 
take them," it can hardly be wondered at. Galileo ancj 
Darwin were primarily scientists, and all they asked wai; 
to be let alone to do their work. Because of their partic 
ular subject matter, they were not greatly interested ir 
religious issues, and became so mainly to the end of try 
ing to protect themselves and their scientific activitic* 
from unwarranted interference. But with Freud the 
situation was different. His subject matter was inherentlj 
closer to that of religion; and if he was not to go alon§ 
with religion (as he obviously had no intention of dd 
ing), then he had to go away from and against it, in a? 
emphatic and militant a way as possible. Hence, as w^ 
have seen, he played the Devil. 

But, much as we may sympathize with both the per 
sonal and the historical situation which, as we may say 
produced a Freud, we cannot at this point in time, regarc 
his total effort as anything but a failure. In fact, thi 
surely is the hallmark of Evil: ultimate disaster afte 
what appears to be great accomplishment and gain. It i 
the long haul that provides the test of Tightness anc 
righteousness; and already, barely two decades afte 

Psychotherapy and the Problem of Values 123 

Freud's death, the signs of confusion and disintegration 
in the movement he launched are rampant. 

During the same two decades there has been a remark- 
able upswing in church attendance and general religiosity. 
But can we be sure that these developments have as yet 
a clear ideology and rationale? There is still a babble of 
tongues in respect to the genesis and treatment of those 
profound and, alas, prevalent disturbances of the human 
spirit which we doggedly dub mental illness. And the 
contradictions between science and religion seem in many 
ways as basic and irreconcilable as ever. But there is upon 
the horizon a ray of hope which comes from as unlikely 
a direction and is as altogether extraordinary as any of 
the other developments which have been considered in 
ithis paper. 

i As a result of a succession of personal and professional 
experiences whose narration will have to wait for another 
occasion, I have become increasingly convinced, during 
the last ten or fifteen years, of the basic unsoundness of 
Freud's major premises and have, literally, read myself 
back into a position which can be at least loosely iden- 
tified as Judeo-Christian. However, it was only recently 
that a book came into my hands which says, and says 
very clearly and confidently, something which is wanting 
in most contemporary religious literature and preaching. 
I refer to Henry P. Van Dusen's book, Spirit, Son, and 
Father (1958). I wish there were time to develop the 
reasons why I feel such great excitement over this small 
volume. Instead we must be content with the merest 
intimation of what Dr. Van Dusen is saying. But first let 
me state, what is of course well known to many, that 
Henry Pitney Van Dusen is no upstart theologian or 
fly-by-night scholar. He is currently President of Union 
flTheological Seminary, in New York City, a member of 
numerous important boards and foundations, and the 
author or editor of some 18 other thoughtful books. And 
Inow he comes forth with an argument which is absolutely 
jrevolutionary and yet is as obvious and plausible as some- 
ithing one has known all his life! 

i The gist of this argument is that in our interpretation 
^of the Christian Trinity, we have erred and confused 
lourselves by making the order: God the Father, the Son, 

124 The Crisis in Psychiatry and Religion 

and the Holy Spirit. Van Dusen, paradoxically and yet 
shrewdly, insists that the aspect of this trilogy which 
has been least emphasized and understood is, in reality, 
the most important and most immediately knowable. 
"Something is lacking, and that which is lacking is what 
is most important" (p. 11), he says with eloquent sim- 
plicity. Dr. Van Dusen quickly gains the reader's con- 
fidence and interest by acknowledging that he, along with 
most laymen, had long regarded the concept of the Holy 
Spirit, or Holy Ghost, as extremely vague and at least 
mildly repulsive and unsavory. And yet, argues Van 
Dusen, there are strong historical and Christian grounds 
for believing that it is through the idea, indeed the ex- 
periencej of the Holy Spirit that all other religious phe- 
nomena and practices are inspired and validated. Then, 
after citing a growing number of other writers who are 
today also taking this point of view, he asks: "Is not this 
the true message of 'Christian Hope* for which our gen- 
eration longs?" (p. 11). 3 

With such phrases as "omnipresence of the Divine in- 
fluence," "immediately present and supernormally power- 
ful," "the moral consciousness," "the very principle of 
personal religion," "the Transcendent God in action," 
"the Immanent God in residence" and by reference to 
the "inner light" of the Quakers, Buchman's "guidance 
of the Spirit," and Kant's "categorical imperative of 
duty," Dr. Van Dusen conveys something of the general 
connotation which he would have us attach to the no- 
tion of the Holy Spirit. He properly notes that it is at 
this level of thought and experience that the "ecumenical 
movement" on the part of various Christian denomina- 
tions finds its soundest and most meaningful justification 
— ^and to this he adds, even more broadly: 

Here, then, is the elemental meeting-point of all religion 
and the proper starting-point for a comparative study of the 
faiths of mankind (p. 99). 

A major, not to say insurmountable, stumbling block 
to the acceptance of Christian orthodoxy for many con-; 

®In correspondence, Dr. Van Dusen has called attention to 
two other pertinent studies. They are Lindsey Dewar's The 
Holy Spirit in Modern Thought (1959) and A. B. Gome's 
Human Spirit and Holy Spirit (1959). 

Psychotherapy and the Problem of Values 125 

temporary men and women is the not uncommon insist- 
ence upon the uniqueness and particularity of Christ and 
of the Divine Revelation through Him. For the scientifi- 
cally trained mind, order, regularity, and uniformity per- 
vade the Universe; and suspension of natural law is as 
unthinkable as is the episodic intervention of supernatural 
powers and agencies. Hence, what the scientist looks for 
in the realm of religion, if he looks for anything, is a set 
of principles and concepts which are universally and 
eternally applicable and operative. In Van Dusen's book, 
what has previously been seen as perhaps least promising 
in the Holy Trinity becomes actually the most promising 
as the basis of a science-religion reconciliation. And the 
significance and workability of this rapprochement be- 
comes especially pointed when one examines, specifically, 
the domain of psychopathology. 


As is of course well known, Freudian doctrine holds 
that the impulses which are bottled up in the neurotic's 
unconscious and there provide the wellsprings of psycho- 
pathology are essentially "evil," i.e., they are, charac- 
teristically, the impulses of hostility and lust.^ Granted 
Ithis premise, the objective of analytic therapy is, logically 
jenough, to release these impulses from repressive control 
I — to let the evil out; and this is why therapy has been 
[conceived at least metaphorically, as the Devil's work. 
|In the neurotic individual, concern over virtue and 
irightness of conduct has, presumably, done its work 
only too well and has to be counteracted. 

*This supposition is so widely known that it hardly needs 
documentation; but since reference has already been made to 
Freud's paper, "A Neurosis of Demoniacal Possession in the 
Seventeenth Century," we may note the particular phrasing 
which Freud there gives to it: "What in those days were 
thought to be evil spirits to us are base and evil wishes, the 
derivatives of impulses which have been rejected and repressed. 
In one respect only do we not subscribe to the explanation of 
these phenomena current in mediaeval times; we have aban- 
doned the projection of them into the outer world, attributing 
their origin instead to the inner life of the patient in whom 
they manifest themselves" (p. 437). 

126 The Crisis in Psychiatry and Religion 

But now we are having to reconsider all this, and the 
most likely alternative position is that neurosis is not a 
result of blocked and outraged biological forces but is 
rather an expression and consequence of "evil" in a very 
different sense. The Freudians, of course, recognize that 
guilt is central to neurosis, but it is always a guilt of the 
future. It is not what the person has done that makes 
him "ill" but rather what he wishes to do but dares not. 
In contrast, the emerging alternative — or, more ac- 
curately, the re-emerging one — is that the so-called neu- 
rotic is a bona fide sinner, that his guilt is from the past 
and real, and that his difficulties arise not from in- 
hibitions but from actions which are clearly proscribed, 
socially and morally, and which have been kept carefull} 
concealed, unconfessed, and unredeemed. Freud's assump- 
tion, consistent with the position just ascribed to him. 
was that man is basically an animal, that his most funda- 
mental nature is biologically ("instinctively") given, and 
that it is cultural and moral interference with "things ol 
the flesh" which make him emotionally sick. From man} 
quarters now comes reaflSrmation of the view that mar 
is preeminently a social being and that for him the su- 
preme anguish comes, not from bodily deprivation oi 
pain, but from the rupturing of his sociality which we 
broadly denote by the word sin or alienation. For ex 
ample, Dr. Karl Menninger (1958), after reading ".A 
New Theory of Schizophrenia," which has already been 
cited at the outset of this paper, wrote to say: 

I very much liked the article. ... I wish you would tell 
[the author] that I think it is fine and that it would be 
even a little better, in my opinion, if he would not try tc 
distinguish between schizophrenia and other groups of symp 
toms. Essentially all mental illness must be a reaction tc 
some kind of feeling of rupture with the social environmenl 
. . . (personal communication).^ 

Clear adumbrations of this point of view can be traced 
back nearly a quarter of a century. In 1936 Anton T, 
Boisen published his epochal Exploration of the Innei 
World, in which he postulated an outraged conscience 
(rather than id) as the basis of neurosis and suggested 

^For more extended statements of this point of view, see, 
among others, Anderson (1959) and Jourard (1958). 

Psychotherapy and the Problem of Values 127 

that there is something potentially constructive and 
growth-producing in such a state of mind. Two years 
later, the erstwhile Freudian analyst, Wilhelm Stekel, 
published a similar point of view in a book which did 
not, however, become available in English and generally 
known in this country until 1950. And in 1947-48 the 
present writer, then unaware of the views of either Boisen 
or Stekel, began the publication of a series of articles 
(see Mowrer, 1950, 1953) in which repudiation and re- 
pression of conscience, rather than id, was likewise 
stressed. Now, again apparently independently of the 
sources just cited. Bishop Arvid Runestam, of Sweden, 
in 1958, published a book entitled Psychoanalysis and 
Christianity,^ in which he writes: 

The psychoanalytic theory about repression, and the wide- 
j spread neuroses based thereon, . . . give the impression of 
j a strong rancor on the part of psychoanalysis toward the 
I needlessly strict censure of the life drive by contemporary 
morality. . . . Psychoanalysis stands forth both in theory 
and practice, by and large, as a potent promoter of the 
right of the spontaneous instinct-guided life to make itself 
effective. It is not as if it means that all morality is evil per 
se. But morality presents itself more as a necessary evil than 
as a positive good. Conscience and the "superego" receive 
the role of operating purely negatively and restrictively on 
that which alone appears to possess the right to life, "the 
life stream" itself (p. 37). 

However, there are two objections to the psychoanalytical 
doctrine of repression. These, by the way, finally unite into 
one. With reference to the notion that it is primarily the 
sex instinct and the emotional energy it involves, which the 
analysts imply have been unduly restrained, one may ask: 
As one looks at the present situation and the contemporary 
moral condition, is there anything that seems to indicate 
that this drive has really suffered such terrible damage? On 
the contrary, is it not at least plausible that the repression 
leading to neurosis is caused by the repressing of other, 
usually considered higher, instincts? Have the religious and 
moral instincts — or, if we do not like to call them "in- 
stincts," those factual, inherited or acquired religious and 
moral forces, emotions, imaginings, needs — ^been treated more 
mercifully by contemporary ruling powers than the lower 

•This book is a revision and translation of a much earlier 
Swedish edition, which appeared in 1932. For its day, the 
wiginal version was prophetic indeed! 

' 128 The Crisis in Psychiatry and Religion 

instincts have? May it not be that these higher instincts, 
needs, and forces, rehgious and moral, have suflfered damage, 
and that repression and neuroses have their bases just in 
this? (pp. 41-42). 

Would it be too large a leap to equate or at least liken 
The Unconscious, as reinterpreted by the writers just 
cited, to the Holy Spirit, as Van Dusen conceives of it? 
If such an identification (or even a partial one) can be 
granted, a new and powerful basis is at hand for the in- 
tegration of psychology and religion. Here is a force in 
human personality and in the Universe whose manifesta- 
tion and functioning can be scientifically studied and 
which, at the same time (according to Van Dusen; see 
also Boisen's reference to ''that social something called 
God") is the heart and essence of religious experience. 

How very different this conception is from the classical 
Freudian one is indicated by the fact that where Freud 
expected to find — and, with the aid of "diabolical" 
strategies, release — Evil, we now believe the Holy Spirit 
to reside! This changing view of the unconscious has 
been more fully developed elsewhere [Chapters 2 and 
8] and cannot be elaborated here. But enough has al- 
ready been said to show how revolutionary all this is from 
a theoretical standpoint; and it is not at all inconceivable 
that corresponding reforms will follow in practice, in 
both religious and psychological circles. Freud, as we havei 
seen, did not take guilt seriously; it was instead in- 
stinctual deprivation and frustration that concerned and 
interested him. One is little short of dazzled by the pos- 
sibilities that seem to lie before us if, for a change, w€ 
were to take guilt seriously and at the same time workec 
out ways of dealing with it which are more realistic anc 
effective than those which have characterized Protestant 
ism and even Catholicism in its least vital forms. 

In his book, Spirity Son and Father^ Van Dusen cite; 
a "bold prophecy" made some years ago by F. D. Mau 
rice to this effect: 

"I cannot but think that the reformation in our day 
which I expect to be more deep and searching than that o 
the sixteenth century, will turn upon the Spirit's preseno 
and life, as that did upon the Justification by the Son' 
(p. 15). 

Psychotherapy and the Problem of Values 129 
And a few pages later Van Dusen himself remarks: 

Time and again, the Holy Spirit has dropped from the 
center of attention because it has been lost from the heart 
of experience; theological crystallization and controversy have 
preoccupied men's minds reliance upon creed and cult, upon 
form and structure, has displaced expectation of new dis- 
closures, sometimes with determinative influence and often 
with baneful effect upon man's conception of the Holy 
Spirit. Always, perhaps at long last, the Holy Spirit has re- 
turned, first as an experience and secondarily as a doctrine, 
to revive men's souls and banish their defeat and despair, 
and then to reanimate the dead skeletons of ecclesiastical 
organization and redeem the dry rot of dogma (pp. 27-28). 

If psychology and religion can join forces, both con- 
ceptually and practically, it is not beyond imagining that 
we shall yet live to see men's souls revived and their de- 
feat and despair vanquished. 


Psychology, Theology, 
and the Social Self * 

Certainly the commonest and, in some ways, the most 
serious objection to the notion that sin or real guilt is 
the root cause of personality disturbances is that such a 
state or condition cannot be objectively, scientifically 
defined. What are the criteria, it is asked, according to 
which we decide what is good or bad, virtue or evil? And 
by implication, if a phenomenon can't be precisely, opera- 
tionally defined, it doesnt exist. Many of us have very 
much wanted to get rid of moral values, to believe that 
reality is ethically neutral, and that experience or action 
is good or bad only insofar as it is followed by pleasure 
(lust) or displeasure (unlust). But gradually we are re- 
discovering that there is more to human existence than 
mere biology and that social systems {and, indeed, per- 
sonality itself) cannot exist without prescribed and pro- 
scribed patterns of feeling and conduct (cf. Chapter 3 ) . 

After some preliminary considerations, we come to 
grips in this chapter with at least one way of thinking 
about the problem of ethics, operationally and objectively, 
and of dispelling some of the wishful doubting in 
which we have previously engaged. Here we also touch 
upon the currently much-debated issue of conformity and 
nonconformity. The charge that values and ethics are un- 
scientific concepts (and therefore not to be taken se- 
riously) seems to be giving way to the view that no 
conception of personality and of society can be truly 
scientific which ignores these considerations. 

* The third of three lectures, on the general subject of 
"Psychoanalysis and the Judeo-Christian Ethic," presented 
February 23-25, 1960, under the auspices of the E. T. Earl 
Lectureship Foundation and the Pastoral Conference of the 
Pacific School of Religion, Berkeley, California. 


Psychology, Theology, and Socl^ Self 131 

In the first lecture in this series, I tried to show that 
man is pre-eminently a social creature — or, in theological 
phrase, a Child of God — and that his greatest anguish 
comes, not from bodily discomfort or instinctual frustra- 
tion, but from violation of his sociality, from estrange- 
ment, from unacknowledged and unatoned real guilt. 
And in the second lecture we examined some of the his- 
torical reasons — or should we say, vagaries? — which 
caused us to abandon this ancient and empirically-based 
position and drift into the style of life epitomized by the 
term 'Treudianism." It is now clear that, despite his 
explicit disavowal of philosophical intent and his insist- 
ence that he was merely a scientist and physician, Sig- 
mund Freud actually conceived of himself as having a 
messianic mission in the world and was aiming at nothing 
less than a cultural and moral revolution. 

But there are now widespread and growing indications 
that the premises upon which this reformation was to be 
founded are unsound and that Freud's aims and motiva- 
tions were not messianic but demonic. We have good 
reason to believe that psychopathology, instead of stem- 
ming from unexpressed sex and hostility, comes rather 
from an outraged conscience and violated sense of human 
decency and responsibility. This radically revised percep- 
tion of the basis and nature of mental illness suggests an 
affinity with both classical and contemporary conceptions 
of the Holy Spirit and points the way to a new synthesis 
of religion and contemporary psychological and social 

How, then, shall we proceed in this, the third and final 
lecture? Since the first two lectures were written some 
months ago, I propose, first of all, that we briefly ex- 
amine and evaluate inten^ening developments and then 
decide upon the direction of our ensuing discussion. 


Although it is not particularly recent, I want to begin 
by citing an invited address delivered to the American 
Psychiatric Association in 1956, by Dr. Percival Bailey. 
Dr. Bailey is Director of the Illinois State Psychopathic 

132 The Crisis in Psychiatry and Religion 

Institute; and his address, which has just come to my 
attention, is entitled "The Great Psychiatric Revolution." 
Here Dr. Bailey reluctantly expresses the opinion that 
the so-called "psychiatric revolution" which was produced 
by Freudian psychoanalysis has come to naught. He says: 

The great revolution in psychiatry has solved few problems. 
... I understand now why, in the last years, I have a! 
recurrent dream that I am wandering through a dense path- 
less forest but never arrive anywhere before I finally wake. 
Lately I have another recurrent dream: A vine, seeking in 
vain a support on which to climb to higher things, twines 
around its own base (p. 402). 

More specifically, Dr. Bailey says: 

It has become a habit, in beginning a psychiatric lecture^ 
to pay tribute to Freud's genius. Thus Montague (1955), 
in his dinner address to this Association, remarked: "This 
general [pessimistic] viewpoint has received what is perhapsj 
its most striking reinforcement from a source which undoubt-1 
edly represents the most insightful contribution to our under- 
standing of human nature in the history of humanity. I 
refer to the psychoanalytic theories of Sigmund Freud," He 
[Montague] then proceeds to demolish the viewpoint. .This 
is an old procedure; Freud (Wortis, 1954) complained bit- 
I terly of it. Still, his teachings continue to arise like a phoenix 
from its ashes. Lately a psychologist was overheard at the 
Chicago State Hospital expounding for the delectation of 
the affiliate nursing students, on whom we spend thousands 
of dollars every year to bring them to our hospitals, the 
discredited theory of infantile parental incest in all its pristine 
naivete. When one remembers how the teaching of Franz 
Josef Gall still colors all our neurological thinking one 
wonders how long the hoary errors of Freud will continue 
to plague psychiatry (p. 395). 

And Dr. Gamilla Anderson, staff psychiatrist at Salem 
(Oregon) State Hospital (and author of a 1957 book 
entitled, Beyond Freud) has, in like vein, remarked in 
a recent letter: 'T cannot help but feel that the equation 
of Freud with the devil [in the second lecture in this 
series] is clinically sound and also socially. I believe that 
we shall not soon overcome his pernicious influence." 

Writing in the Reader's Digest for January, 1960, 
Dr. H. J. Eysenck, Director of the Psychological Labo- 
ratories of the Institute of Psychiatry at the University. 

Psychology, Theology, and Soclu. Self 133 

of London, in an article entitled, "What's the Truth 
about Psychoanalysis?" points out that psychoanalysis is 
no more effective in the cure of personality disorders than 
the mere passage of an equivalent period of time would 
be. Like Dr. Bailey, Eysenck also refers to the revolution 
which analytic theory and practice supposedly brought 
about in psychiatry and then observes laconically: 

The success of the Freudian revolution seemed complete. 
Only one thing went wrong: the patients did not get any 
better (p. 40).' 

Many of you will also have seen the 21 -page spread in 
Look Magazine (for February 2, 1960) entitled *Tsy- 
chiatry — The Troubled Science." And particularly sig- 
nificant was the appearance, last year, of a book by Pro- 
fessor Richard LaPiere, of the Department of Sociology 
of Stanford University, entitled The Freudian Ethic. The 
Saturday Review y for August 1, 1959, ran a six-page 
Isynopsis of this book, entitled 'The Apathetic Ethic." 
There are many arresting and quotable passages in this 
synopsis (as in the book itself), but the following catches 
the general tenor and flavor: 

As a code of conduct the Freudian ethic, as it will be 
termed hereafter, is entirely negative. It is composed of 
sentiments and attitudes regarding man's capabilities which, 
if literally applied, would keep him from attempting any- 
thing positive, to say nothing of attempting to devise any- 
thing new. Some appreciation of this state of mind can, 
perhaps, be gained from the terminology used by those who 
subscribe to it. In their discourse there is recurrent reference 
to guilt feelings, personal insecurity, instability, frustration, 
trauma, and "tensions." Such terms are used in reference not 
only to recognizably abnormal individuals but to everyone. 
Still more revealing is the total absence in the Freudian 

^Analysts were always frank to admit their lack of success 
ivith paranoid personalities and the addictions, including alco- 
lolism. What conditions did this leave in which to achieve 
heir so-called "triumphs"? Basically, anxiety states and depres- 
jions, which tend to be naturally self-limiting and transitory 
(though often recurrent). Thus, if a person is in analysis two 
Dr three years, it is not unlikely that he will find himself feeling 
1 good deal better. But there is serious question as to how 
nuch credit analysis can take for it. The chances are the person 
jvould have improved anyway. (Cf. Freud, 1937). 

134 The Crisis in Psyciiutry and Religion 

discourse of such terms as self-confidence, personal integrity, 
self-reliance, responsibility, or such an earthy term as "guts" 
(p. 40). 

Also pertinent to our purposes is the following passage: 

It is the thesis of this study that many of the changes 
that have been of late years occurring in our society are 
malfunctional and that they will, if they continue uncor- 
rected, constitute our unrecognized road to disaster. These 
changes are being wrought by men of many kinds and 
various functions — by psychiatrists and child psychologists of 
the Freudian persuasion, by permissive parents and progres- 
sive teachers, by welfare workers and impressionable judges, 
by managers of business and industry and leaders of labor 
and academic life, and by politicians and political adminis- 
trators of many sorts. Moreover, they are being demanded 
or welcomed, or at least passively accepted, by almost every- 
one (p. 44).^ 

Here I would suggest one or two not unimportant 
emendations of Professor LaPiere's statement. By some; 
odd coincidence, he fails to mention that professional 
group which, just at present, is probably doing more than 
any other to perpetuate what he calls the Freudian Ethic. 
At a time when psychiatrists and psychologists are rather 
generally abandoning psychoanalytic theory and practice, 
ministers and theologians are, as a group, subtly or 
stridently advocating it. I realize, of course, that there' 
are many clergymen who are outstanding exceptions to 
this observation; but as a profession, theologians are at 
the moment, it seems, more heavily under the sway of 
Freudian ideology than any other comparable group, in- 
cluding psychologists and, quite possibly, even psy- 
chiatrists [Chapters 4, 6, and 9]. 

The churches and the seminaries are, I believe, actually 
in process of house cleaning and will presently recover 
from this aberration. Recently, I had the privilege of 
hearing a tape recording of the keynote address delivered, 
in August of 1959, by Harvey Cox at the opening session 
of the annual meeting of The National Student Councils 

^ See also a series of three lectures entitled "Rake's Progress 
in Religion" delivered by Dean R. E. Fitch during the 1960 
Pastoral Conference of the Pacific School of Religion, Berkeley, 

Psychology, Theology, and Social Self 135 

of the YMCA and YWCA. Allow me to quote an ex- 
cerpt from this tape. Having cited the Columbia sociolo- 
gist, C. Wright Mills, on the distinction between "trou- 
bles" and "issues," to which we shall return presently. 
Cox says: 

As a student YM and YW, I think we have been smitten 

by a hasty love affair with depth psychology, with troubles, 

I with symptoms. Think of all the ink spilled over discovering 

I myself, of unmasking and revealing each other's true and 

J undisguised egos. I think we've had about enough of the 

Who-am-I? bit. Think of the countless programs we've had 

trying to answer this somewhat misleading question. And 

then think just how far this is from Biblical radicalism. 

I A member of the Salvation Army also recently gave me 
1 quite remarkable piece of information. The "Army," it 
ippears, keeps "statistics." And what do they show? Some 
/ears ago this organization, along with religious denomi- 
lations generally, decided that it was losing out on a 
jood thing and that it, too, should go in for the "depth 
psychology" alluded to by Mr. Cox. And what is the 
esult? A steady decline in the effectiveness of this organi- 
sation in salvaging lost, disorganized men and women. A 
iirective has therefore gone out from the Commissioner, 
it the Salvation Army's Headquarters in Chicago, to its 
ichools and training centers to abandon the "depth" ap- 
)roach and revert to its more traditional methods.^ 

There are, I believe, many similar trends in our more 
;onventional religious denominations. But a confusing 
lomplication exists here, namely, the unprecedented re- 
lent upsurge in church attendance and membership. I 
)ersonally do not doubt that this "return to religion" is 
omewhat related to the renewed interest on the part of 
ilergymen in personal problems — to the resurgence, that 
s, of personal counseling, and of the impact of this inter- 
;st upon the pulpit ministry. But I would ask you also 
consider the alternative interpretation offered by 
larvey Cox. He says: 

For myself, the return to religion is only evidence on the 
wrong side. I think most of it is simply a speed-up in the 

'^Cf. God at the Scrap Heaps by H. F. Milans (1945) and 
I. L. Brengle's Helps to Holiness (1948). 

136 The Crisis in Psychiatry and Religion 

anxious effort to cling to a 19th-century style of life which! 
has on it the mark of futility. 

And the fact that a person of my own persuasions has 
been invited to give these lectures, here at the Pacific 
School of Religion and the 38th Annual Pastoral Confer- 
ence, this year is, it would seem, yet another indication of 
the willingness of churchmen at least to entertain the pos- 
sibility that they have been, literally, mis-taken in this 
area and need to reconsider their own great traditions; 
and indigenous potentialities. This is not, by any means,- 
to say that all we need is simply to return to pre-Freudian 
theology and doctrine. As I tried to indicate in the second 
lecture, psychoanalysis came as a judgment upon 19th- 
century religious ideology and practice. But we must not 
take the judgment, the indictment, the curse itself as the 
cure-^which, as I see it, is substantially what many thci 
ologians have been disposed to do. 

In short, what I have just suggested is that on-going 
developments indicate, with every increasing clarity, the 
steady deterioration of what Professor LaPiere has aptly 
called the Freudian Ethic and that we have no choice 
but to get about the business, at once, of finding some- 
thing more suitable and substantial to take its place. 
Conant's dictum that, in science, a theory is never over- 
thrown by contradictory facts, only by another, better 
theory, is well known. Surely empirical evidence tending 
to refute Freud's basic assumptions has been lying pro- 
fusely about all the time. But 19th-century theology had 
manoeuvred itself into so many metaphysical absurdities 
that when Freud came along with his brazen and bril- 
liantly formulated heresies, the Church was no match for 
him. Now we see Freud in a truer light, not as Messiah 
but as Deceiver, and the Church will continue to pay 
homage to him at its peril. 


For several years now, during the Summer Session at 
the University of Illinois, I have taught a course in our 
College of Education entitled ''Mental Hygiene foi 
Teachers"; and when we get about half or two-thirds 
through this course (which covers much of the same 

Psychology, Theology, and Social Self 137 

ground we have explored in these lectures, although more 
systematically), students regularly begin asking: So what 
can we do about the situation? As the diagnosis of our 
predicament becomes clear, they begin asking about the 
prognosis, the prescription for corrective action. In the 
past I have been compelled to say that I did not know 
the answer. But the situation is, I believe, gradually 
becoming clarified. As I have already indicated [Chapter 
i7], it would appear that the Church must become con- 
cerned, in a new and more vital way, with the problem of 
mental illness. No longer should it take a position of sub- 
servience to a profession which, by its own admission, 
has failed to solve this problem [see, for example. Chap- 
ter 4]; instead, it must approach the problem indig- 
enously, that is, in terms of religion's own great insights 
and authority. And if its present precepts and principles 
are not sufficient to this task, they must be modified and 
revised until they are. 

As part of such a program, it seems clear that we are 
moving toward a reinstitution of regular confession in 
the various Protestant denominations. 'Tastoral counsel- 
ing" is merely a euphemism for a voluntary, nonprescrip- 
tive form of confession; and this, if handled rightly, can 
unquestionably be helpful — far more so, I believe, than it 
ordinarily is at present. But we also need to move on 
from the prevailing medical notion that one goes for 
"help" or "treatment" only after one is in trouble, i.e., 
already "sick," to an active program of prevention; and 
it is here that the obligatory aspect of confession takes 
on special urgency. There is at present considerable 
receptivity to this idea; and I should not be surprised 
to see it effectively implemented in the near future, 
particularly in Lutheran and Episcopal circles. 

I realize, of course, that these statements, without the 
full context from which they derive, may sound arbitrary 
and, to some, perhaps even heretical; but in the Nyvall 
Lectures this spring, I hope to develop this train of 
'thought in a fully documented and more persuasive man- 
ner [see Chapters 11 and 12]. 

What remains, then, for us to consider this evening? 

I believe that in order to round out the argument and 

ijanalysis launched in the first two lectures in this series 

iwQ should employ the remainder of our time together 

138 The Crisis in Psychiatry and Religion 

along the following lines. For some decades now, we have 
been in the habit, whenever a person was deeply troubled 
and disturbed, of saying: He (or she) "needs therapy." 
At last we are waking up to the fact that the "therapy"! 
we have been so blandly prescribing for others (and our-i 
selves) is fundamentally worthless — a "therapy" which 
does not heal and which, as a general social philosophy 
and guide to life, is downright pernicious. Now we are 
beginning to realize that the commodity which practi- 
tioners of this dubious art have been selling for $25 to 
$50 an hour, or whatever the market will bear, is a snare 
and delusion and that a radically different approach is 
called for. Now, instead of talking just about "sick" in- 
dividuals, we are beginning to talk about a sick society; 
and I submit that an important aspect of this generalized 
sickness is the very fact that we speak of our individual 
and collective diflSculties as "sickness," rather than as sin 
or evil. As Professor LaPiere has pointed out, sickness is 
a stultifying and enervating concept; by contrast, there is 
something salutory and vitalizing about the notion of evil. 
It gives us, by implied antithesis, a new vision of the good 
and something to work for, something positive and sub- 
stantial on which Dr. Bailey's "vine" can cling and grow. 
In short, then, it seems that what we have been calling 
"therapy" itself needs "therapy," and when this becomes 
the case, the nature of the problem shifts into a whole 
new register, a different universe of discourse. Some years 
ago, Rollo May (1953) pointed out that whenever there 
is widespread need for individual psychotherapy in a. 
society, there is an institutional and structural crisis in 
that society. And Harvey Cox, in the address already 
alluded to, develops this thought even more explicitly. 
Having cited C. Wright Mills for the distinction between 
troubles and issues, he says: 

Troubles are personal, singular, and individual. Issues are 
structural, general, pervasive. When one man can't get a 
job, that's trouble; when six million men are out of work, 
that's an issue. When an occasional couple can't make a 
marriage work, that's trouble — maybe very serious trouble. 
When the divorce rate climbs to a failure of one out of 
three marriages, that's an issue. 

Now I submit that in the psychiatry-religion area, we 
are today confronted, not just by troubles — i.e., individ- 

Psychology, Theology, and Social Self 139 

ual failures to function within an essentially sound in- 
stitutional and ideological framework — but by issues, 
deep, pervasive questions of such urgency that, as Pro- 
fessor LaPiere suggests, our collective as well as individual 
survival may well depend upon the way in which we re- 
spond to them. Therefore, in the time that remains this 
evening, I propose that we continue our quest for clarifi- 
cation of these issues, on the assumption that this is a 
;necessary prelude to, or at least concomitant of, practical 
reconstruction and reform. 

In thus stressing the importance of intellectual analy- 
|sis, I realize the danger of being taken in something of 
a contradiction. On other occasions [see, for example. 
Chapter 3], I have argued against the therapeutic impor- 
itance of "insight" and sheer theoretical ''understand- 
ing" in favor of concrete modifications of behavior. In- 
formally, I have often cited an aphorism by E. Stanley 
Jones to the effect that it is easier to act yourself into a 
new way of thinking than to think yourself into a new 
way of acting. And Lloyd Douglas commonly has char- 
acters in his novels admonish others to seek the ''under- 
standing" that comes, not from mere thought and talk, 
but from actually trying out another life style and inter- 
personal strategy. "Make an investment, perform an ex- 
periment," is Douglas' terse way of putting it. 

Now Jones, and Douglas, and Cox are not, I believe, in 
the least disparaging the normal interplay of thought and 
action. Rather are they rebelling against the interminable 
rumination and "free association" that goes on in psy- 
fchoanalysis and related procedures, with an explicit ban 
on experimentation with new types of action, new pat- 
terns of conduct and life style. During a classical Freud- 
ian analysis, the patient is expressly forbidden to make 
any major decisions or changes, in his life, on the 
grounds that while the treatment is in process he will not 
be competent to do so and might make serious mistakes. 
The patient, while in treatment, may be encouraged to 
"reality test" in the matter of greater expression of sex 
and aggression; but anything so radical as turning over a 
new leaf and trying to put one's moral house in order is 
strenuously discouraged. 

One of the many paradoxes that have beset psycho- 
analysis is that while maintaining the essential irrational- 

140 The Crisis in Psychiatry and Religion 

ity of man, it put its supreme trust in verbal operations 
and neglected the power of what G. H. Mead has called 
the concrete social act. Small wonder, therefore, that 
analysis often stretches out interminably and in the end 
— if there is an end — leaves the analysand in an intel- 
lectual and emotional morass. Somewhat parenthetically, 
yet with all seriousness, I want to suggest that the com- 
fortable and well-to-do classes in our society have been 
trying to buy forms of personal redemption not nearly as 
potent as those cures or "therapies" to which the poor 
have always been limited. I am thinking not only of Al- 
coholics Anonymous, but also of the dramatic transforma- 
tions of men and women which the Salvation Army fre- 
quently achieves; and there is even evidence — see for 
example Boisen's book, Churches of Crisis and Custom 
— that certain practices in the so-called sect churches are 
drastic but potently restorative.* In other words, I am 
suggesting that the time has come when we must recog- 
nize that, in our efforts to purchase a form of salvation 
which is supposedly better and less crude than anything 
which the poor can afford, we have been, in effect, wast- 
ing our money. There is no clear evidence of the efficacy 
of professional psychotherapy — certainly nothing to com- 
pare with the manifest transformations achieved by AA 
and the Salvation Army; and I have often wondered if, 
when we find we ''need therapy," we would not be better 
off if, instead of getting a so-called therapist and paying 
him a generous fee, we gave the same amount of money 
each week to some really good cause. 

A Swedish psychoanalyst, Dr. Nils Haak, who has written 
extensively on the importance of high fees, says the belief 

* I am thinking, for example, of a story which a minister 
of one of the so-called sect or "fringe" denominations told 
me recently of the way in which confession before his congre- 
gation, demanded by the authorities of his group when he was 
apprehended in homosexual practices, cured him of this per- 
version, then and there, and laid the basis for successful mar- 
riage and parenthood. In secular psychotherapy, by contrast, 
we are ordinarily content with much smaller changes or "move- 1 
ment." Some years ago a dramatic critic, in commenting on the 
performance of Katharine Hepburn in a play, remarked that 
she had run the emotional gamut "from A to B." A similar 
characterization is in order with respect to the results of psycho- 

Psychology, Theology, and Social Self 141 

that what is cheap is of httle value is deeply rooted in the 
human mind. He argues that by demanding a high fee, the 
analyst appears to the patient as a forthright individual who 
dares to be honest about money. This makes the analyst a 
fine person for the patient to emulate. A high fee, Haak 
says, also prevents the patient from feeling infantile and 
becoming dependent upon his analyst. For the neurotic 
patient who likes to hurt himself, the making of large pay- 
ments to the analyst, according to the Swedish doctor, is 
an excellent outlet for neurotic feelings. If the analyst were 
to allow the patient to pay only a small fee, it might give 
him a humihating sense of gratitude that would interfere 
with his therapy. There is also the attitude of the analyst 
j to consider, according to Dr. Haak. If he charges a low 
I - fee, the analyst may begin to doubt his own motives for 
doing so. He might wonder whether he is in love with his 
patient, or if he really hates the patient and is trying to 
I cover up by being kind. This sort of thing can seriously 
I interfere with the analyst's abihty to help (p. 45). 

Some of you will no doubt recognize the foregoing 
quotation as a part of R. H. Berg's recent article in Look 
Magazine to which I made reference earlier. Another 
argument which is sometimes advanced is that what the 
analyst offers the patient is primarily his close attention 
as the patient talks and that if he, the analyst, has any 
financial worries he is likely to be distracted by his own 

Dr. Haak conjectures that anything that comes cheap 
is likely to be perceived as being of little value. More 
pertinent to the situation would be the observation that 
a commodity, such as psychoanalysis, can cost a lot and 
still be worthless, except, as he implies, for the masochis- 
tic or symptomatic relief it involves. I submit that if we 
need to make a sacrifice, there are morally and socially 
more relevant ways of doing this than supporting a psy- 
phoanalyst in a penthouse. 

I But this is something of a digression. The point I want 
to make is this. Mere thinking, talking, analyzing will 
not save us; our final redemption can only be found in 
1 radically changed life style. The capacity to make such 
1 change is often dependent, at least to some extent, 
jpon new visions, new conceptions which we acquire 
ntellectually; and it is upon this assumption that I sug- 
gest we continue our attempt to clarify certain matters 

142 The Crisis in Psychiatry and Religion 

which currently seem to be the source of considerable 


If a significant aspect of our great sickness as a people 
and as a society is that we speak of sickness rather than 
of sin, and guilt, and evil, then it follows that we must 
reconsider these concepts. This, however, is not easy for 
us. We are unaccustomed to thinking in these terms and 
find them quite uncongenial. At the opening meeting of 
a graduate seminar this semester, the very first question 
raised by the students was: But what is guilt? Psycholo- 
gists and psychiatrists, along with many religious leaders 
and the general laity, have been taught to think in terms 
of guilt feelings, that is to say, a sense of guilt which is 
unrealistic and nonfunctional and which you can get rid 
of only if you can find, and afford, a really ''good" 
therapist. The notion that guilt is real and not to be 
banished by mere talk or ''counseling" or "analysis" is 
quite beyond our common comprehension. 

Historians of the future may be able to discern more 
clearly than we do today the circumstances which caused 
us, as a people, to drift into this remarkable condition. 
No doubt the true and complete explanation is complex; 
but a prominent factor in the situation which I believe 
we can already see with some clarity is that the traditional 
guardians of our moral and spiritual values have insisted 
upon speaking of these matters in terms and in a con- 
text which are no longer very meaningful to the mental- 
ity and thought forms of modern man. One of the rea- 
sons, I believe, for the current popularity of Paul Tillich 
as a theologian is that he has had the courage and dis- 
cernment to be so nontheological in the conventional 
sense of that term. Recently I met with a group of minis- 
ters who quickly identified me, in their minds, as an un- 
regenerate naturalist and not at all to their theological 
taste; and a few hours later I met with a university faculty 
group, in the same community, who perceived my posi- 
tion as morally reactionary, unscientific, and, as far as 
they were concerned, theological and supernaturalistic. 
More than anything that has happened in a long time, 

Psychology, Theology, and Social Self 143 

this experience brought home to me the extent of our 
diversity and confusion and our egregious lack of unity 
in this area. This is not, I beHeve we would all agree, a 
healthy state of affairs. There is, in our time, no social, 
moral, and ethical solidarity and confidence. The diffi- 
culty with the position of traditional theology is that its 
logic and thought forms are foreign to the modern mind; 
and the problem for the individual who is imbued with 
what he believes to be a thoroughly scientific and objec- 
tive world view is that he may be unable to find therein 
any place for moral values, standards, and ethics. Tradi- 
tional theology was the original thesis (if we may use 
the familiar Hegelian paradigm); scientific naturalism 
has been the strident antithesis; and from this clash 
must come, I believe, a new synthesis of some kind 
(Mowrer, 1959). I, personally, cannot envision this new 
ethical frame of reference with great clarity; but there 
is one facet of the picture which seems to me perfectly 

There is, in our time, a widespread distrust of moral 
injunctions and values which is at least rationalized by 
the following argument. To be good, it is argued, is to 
conform to existing rules and social prescriptions; and 
these, it is pointed out, may be either outmoded or 
otherwise nonfunctional; and if we obey them, then we 
perpetuate them and so are not being good but, in 
reality, stupid and evil. 

Some years ago I recall a young married woman who 
came to me in considerable distress because her husband, 
with whom she was very much in love, "played around," 
as she put it, with other women when they went to 
social parties. The husband, who also valued the marriage 
and by no means wished to lose his wife, later agreed to 
come in for a talk; and it soon came out that he justified 
his philandering at parties on the grounds that he aspired 
to be a writer and felt that he needed a little extra titilla- 
tion and romance in order to be "creative." 

In a sort of microcosm, this marital situation symbol- 
izes at least a part of our larger problem: we pretend 
to be afraid of convention and morality and social regula- 
tion and order on the grounds that it will stifle so-called 
rogress, invention, discovery, creativeness. One imme- 
iately sees, of course, how easily such a formula can be 

144 The Crisis in Psychiatry and Religion 

used to justify and excuse the most blatant instances of 
immaturity, selfishness, and moral laxity. There is, how- 
ever, a legitimate side to this argument which must be 
faced. Leaving aside those who are obviously exploiting 
this dilemma in a personal way, there are many contem- 
porary men and women who are sincerely wondering how 
one can be good, in the sense of conforming to an es- 
tablished social code or system, without also losing that 
spontaneity and creativity which we so greatly value today 
and regard as essential to meeting the unpredictable 
needs of our changing civilization. Here, surely, is the 
essence of our dilemma: on the one hand we seem to 
find that the penalty for disregarding the rules of society 
is mental illness and that, on the other hand, we must 
preserve our freedom to change and try new ways of life. 

Actually, I do not believe this paradox is half so diffi- 
cult as we sometimes try to persuade ourselves, and so 
suggest the following way of looking at it. Let us imagine 
a man (which is not hard to do) who does not like to 
pay his income tax. He has, as I see it, four alternatives: 

L He can pay his tax, accurately and honestly, and 
say nothing about his disgruntlement. He may feel that, 
given the present state of world affairs, there is not much 
he can do about the problem and that he is, in any event, 
more interested in other things. Now despite the wide- 
spread presumption (stemming from Freudian theory) 
that it's bad for us not to express our annoyance, there 
is not the slightest evidence that this sort of restraint 
ever made anyone emotionally ill or destroyed his char- 
acter. It may not be the most ''creative'^ way imaginable 
of meeting situations of this kind, but it is at least a 
perfectly respectable and safe one. 

2. Or, a man, faced by the tax dilemma, can again 
pay his taxes, accurately and honestly, but then make 
whatever protest he feels is in order. In this particular 
instance, he is likely to discover, rather quickly, that just 
grumbling accomplishes little or nothing and that he 
must look for the conditions and causes behind the 
present tax situation. He may, as a result, become 
staunch supporter of the United Nations, as a vehicle 
for promoting greater international law and order, thus 
lessening the threat of war and the necessity for ruinously 
costly competition in the arms race. The point is that 

Psychology, Theology, and Social Self 145 

just because one scrupulously obeys a law or regulation 
does not in the least mean that one cannot work — 
openly, honorably, and effectively — for its modification. 

3. Or, our hypothetical individual can pay none or 
only a part of his income tax as an open and avowed 
protest. He may be sent to prison for his pains; but we 
must not forget that the method is an honest one and 
can be extremely powerful. In modern times one of the 
most dramatic examples of its effectiveness was the 
campaign of nonviolent resistance to British rule which 
Gandhi and his followers mobilized in India. The Indians 
were oppressed, to mention only one example, by the 
price of salt, which was a government monopoly, and 
were forbidden (by what were known as the odious Salt 
Laws) to make salt for themselves from the seawater 
which was freely available to them. So Gandhi announced 
that he was going to walk a distance of some hundred 
and twenty miles to the sea and openly make salt in 
defiance of the regulations of the British government; 
and he invited others to join him, which they did by the 
hundreds. "'When attacked, beaten, or imprisoned by 
the officials, do not resist, do not flee, do not fight back," 
Gandhi urged. "Our oppressors will soon have no heart 
for beating us further, and the Salt Laws will be re- 
voked." As a result of this heroic March to the Sea, 
as it is now called, the Salt Laws were revoked; and 
eventually application of the same powerful strategy — 
of open, nonviolent resistance — completely broke British 
rule and resulted in a Free India. Here, surely, was a 
power, a moral power, more effective than club, sword, 
gun, or bomb. Limited nonconformity with openness, 
integrity, and courage is available to us all, at all times; 
and it can be as mighty as the mustard seed alluded to 
by Christ in the parable. 

I say limited nonconformity. Why limited? Because, 
in the example given, Gandhi and his followers were, in 
fact, scrupulously observing a higher law than the one 
they were violating: they kept their honor, their openness, 
their integrity — and the world respected and will not 
soon forget them. This observation now leads us, by 

I contrast, to the fourth way in which one may try to 
deal with a rule or regulation which one finds incon- 
venient or otherwise objectionable. 

146 The Crisis in Psychiatry and Religion 

4. Let us return to the income-tax example. Here the 
individual again does not pay his tax or pays it only ; 
partially, but then implies or claims that he has paid ; 
it in full. His legal crime is thus compounded by deceit, 
hypocrisy, and dishonor. And far from making a man I 
strong, as Gandhi's Salt March did for those who took ; 
part in it, this strategy destroys personality. In our time ' 
two seemingly unrelated things have happened: on the | 
one hand, mental illness has defied our best efforts to i 
understand and control it; and, on the other hand, we 
have developed a widespread distrust of moral law and 
principle. Only recently, within the last few years, have 
we come to realize that there may here be a very vital 
and important connection. Some of us now suspect 
hidden guilt as being the central problem in all psycho 
pathology. Integrity and integration, we note, come from 
the same root: and it now appears that we cannot have 
one without the other. Cheating and chiseling erode 
character as they devitalize society. If we accept the 
benefits and privileges of a given social system, then we 
are honor-bound to observe the regulations and rules of 
that system, unless we are willing to defy the system 
openly and take the consequences thereof. 

Obviously one can think of abnormal conditions such 
as when a country is over-run by an enemy or such as 
the Jews encountered in Nazi Germany in which all 
manner of ethical dilemmas arise. But the circumstances 
under which most of our crack-ups occur involve no 
unusual or extenuating circumstances. Of course, we 
hear much today about how our society as a whole is 
"sick" and that one can survive only if one defies — 
rather than obeys — it. This, again, seems to me to over- 
look a very elementary distinction, namely, that between 
personal sin and corporate sin. Vance Packard is entirely 
correct when he points out that whereas we once looked 
upon waste and conspicuous consumption as an evil, we 
now are openly encouraged in it as an aid to an ''expand 
ing economy." I believe that in our world the doctrine 
of an "expanding economy" is an evil, but it is a cor 
porate evil. By its very nature it is public, and we are all 
more or less involved in it. The time will come, I predict, 
when we are going to repent it bitterly; but I don't think 
it's going to make anyone go crazy. The very fact that 

Psychology, Theology, and Social Self 147 

we are all in it together means that there is no loss of 
sociahty, no estrangement from the significant others, 
and so no madness. 

By contrast, personal sins are those which the com- 
munity does not condone, may in fact severely censure, 
and which the individual, if he commits them at all, 
commits privately, secretly. Blind and unwise as our 
society may be in its current economic presuppositions, 
it is still pretty well consolidated, it seems, with respect 
to a lot of things; and it is in the areas in which virtually 
everyone is at least overtly agreed that personal sin, 
secrecy, and psychopathology follow in that order.^ Re- 
cently I heard a state hospital psychiatrist comment on 
how frequently incest figures in the background of the 
patients whom she sees. Does anyone really think that 
incest is a fine thing and ought to be generally practiced? 
I doubt it. Yet it does occur, and I do not believe anyone 
can long bind his guilt with respect to it by talking about 
the moral absurdities and ambiguities "of society." Be- 
sides, as I have tried to show, there is a perfectly straight- 
forward way of fighting corporate sin without in the least 
compromising oneself, i.e., falling into personal sin. 
Personal sin occurs, as I see it, and sows the seed of 
psychological destruction when and only when the in- 
dividual violates a social injunction or regulation but 
pretends that he has not. 

I wish to conclude this section with a moving and 
prophetic quotation from Dietrich Bonhoeffer. In his 
book, Life Together, he says: 

In confession the break-through to community takes 
place. Sin demands to have a man by himself. It withdraws 
him from the community. The more isolated a person is, the 
more destructive will be the power of sin over him, and the 
more deeply he becomes involved in it, the more disastrous 
is his isolation. Sin wants to remain unknown. It shuns the 

° Occasionally I have been invited to expatiate on the 
concept of Original Sin. If I allowed myself to do so, I would 
really lay myself open to the charge from theologians of prac- 
ticing their profession without a license. But, for whatever it 
may be worth, my untutored layman's opinion is that this 
doctrine is nonsense, as is that of the Substitutionary Atone- 
ment, and has done much harm in the world [cf. Chapters 
11 and 12]. 

148 The Crisis in Psychiatry and Religion 

light. In the darkness of the unexpressed it poisons the whole 
being of a person (p. 112). 

And Eric Fromm, in his book The Art of Loving, 
says without equivocation, that the loss of relatedness 
and community is the ground of anxiety and the begin- 
ning of insanity (see also Kirkendall, 1960). 


If the foregoing analysis is sound, the condition which i 
we currently refer to as neurosis or psychosis is the same 
as that which an earlier era knew as a state of sin or dis- 
grace; and the defining characteristic of both is the 
presence in one's life of shameful secrets. When Have- 
lock Ellis was once asked what he thought of Freud's 
ideas, he dismissed the question by saying that, in his 
opinion, personality difficulties are due, not to the uncon- 
scious, but to the unuttered. Freud's theory has, however,, 
had a diabolical fascination for us; and it is only now 
that we are beginning to realize how thoroughly mislead- 
ing and destructive it is. 

If it is indeed the untold rather than the unknown 
that devastates us as persons and robs our lives of joy 
and meaning, how can this view of the matter be given; 
a theoretical formulation approaching in elegance and 
plausibility that of psychoanalysis? In a moment I shall, 
have a suggestion to make in this connection, but first a 
collateral observation. When a neurotic (sinful?) person; 
is asked, ''What makes you so anxious, so depressed, so 
distraught?" he is likely to reply that he does not know.: 
And the Freudian rejoinder is then, typically, "Yes, that 
is true. You don*t know the causes of your troubles. ^ 
They are repressed, unconscious, and thus beyond your: 
unaided capacity to deal with. How fortunate, therefore,' 
that psychoanalysis is available to you as a method of 
making the unconscious conscious and thus helping! 
you discover the real origin of your difficulties and mak- 
ing you then able to deal rationally with them." 

I remember hearing John Dollard some years ago, 
when we were both on the staff of the Yale Institute 
of Human Relations, once remark that whatever Freud's 

Psychology, Theology, and Social Self 149 

scientific contributions might be, he had certainly started 
a big business. Now, more clearly than before, we can 
see the nature of that business. Certainly no one is going 
to get rich telling others that their emotional turmoil 
comes from unconfessed and unexpiated sin. That road 
to redemption is too rough, and we shun even the 
thought of it if we possibly can. The Freudian doctrine 
is, of course, very different — far more pleasant sounding 
and appealing. According to it, we are not "to blame" 
for our suffering; but — and here is the joker — ^by the 
same token neither can we do anything about our condi- 
tion by ourselves. Only the psychoanalyst can save us; 
and this he is very willing to do, he says, provided we 
can pay him sufficiently well for his eflforts. For the poor, 
as the Hollingshead-Redlich New Haven study has 
shown, psychoanalysis has never been a live option; and 
it is no accident that it is among them that we find other, 
simpler, and more radically effective methods of salvation 
at work. Also, as Bonhoeffer in his book. The Cost of 
Discipleshipy has indicated, many Christian churches 
have similarly tried to provide, for those who can afford 
it, a doctrine of salvation through forgiveness uncom- 
plicated by personal embarrassment, genuine contrition, 
and meaningful restitution. This, Bonhoeffer has called 
"the doctrine of cheap grace"; and because it is cheap, 
in personal involvement, sacrifice, and change, it is no 
grace at all. Despite its exorbitant fees, psychoanalysis 
also preaches a doctrine of cheap, easy grace. If you can 
only pay for it, buy it, someone else will do the real work 
of curing you, while you lie comfortably on a couch. 

One of the crying needs of our time, surely, is for a 
therapeutic (redemptive) alternative which is available 
to the well-to-do, without carrying the illusion that we 
Can purchase it with mere money instead of at the per- 
gonal cost which the poor have always had to accept. 
Jesus Christ, we need to remind ourselves, was a poor 
Itnan. He and his disciples moved about on foot, preached 
land taught in the open, without benefit of costly church 
or temple, and their appeal was to the poor. I. A. Rich- 
ards once observed, ironically, that every profession is 

conspiracy against the laity. The truth of this statement 
lES regards psychoanalysis needs no elaboration. In a 
'slightly more benign way, the same charge can, I believe, 

150 The Crisis in Psychiatry and Religion 

also be directed against theologians and clergymen. In 
the Catholic Church, they openly claim to derive their 
unique power to forgive sins as a result of the so-called 
direct apostolic succession. And while making no such 
claim in this area, Protestant theologians surround Chris- 
tianity with other mysteries which only they can presum- 
ably interpret. I take it as suggestive, again, that the 
most radically redemptive enterprises which we today 
know, notably the Salvation Army and Alcoholics Anony^ 
mous, are lay movements with their ''leaders" coming, 
not from our universities and seminaries, but from the 
Tanks of their own converted and transformed personnel. 
Here the Priesthood of All Believers is more than a high- 
sounding Reformation slogan; it is a living reality. 

But to return, now, to the attempt to schematize the 
strategy of deception and personal fraudulence which, 
we conjecture, is the uniform precondition of emotional 
or, as we might better say, moral disturbance. Freud 
thought in vivid, graphic similes and communicated his 
ideas, abhorrent though they were, in a clear and mem- 
orable way. Only the parables of Christ himself compare 
perhaps in trenchancy and heuristic aptness and are 
actually inferior, at least by modern standards, as a con- 
ceptual scheme. Hence, the task of formally systematizing 
the alternative to Freudianism which seems to be emerg- 
ing — or, rather, re-emerging — remains for the future. The 
sociologist, George Herbert Mead, made some notable 
steps in this direction, as did Harry Stack Sullivan within 
the psychiatric framework and also Martin Buber, as i 
theologian.'^ Here I shall make no attempt to revie>^ 
or synthesize their respective contributions but will in 
stead suggest a heuristic device which I have found effec- 
tive on other occasions. 

In class one day I found myself drawing a straight line 
across the blackboard, from left to right, as a means ol 
depicting normal, upright day-to-day human living. A. 
morally and emotionally healthy person, in commor 
parlance, is said to be on the up-and-up, predictable 
consistent, a straight shooter. This is not, of course, tc 

"^ Of special interest in this connection is a book by P. E 
Pfuetze which systematically relates and compares the writing: 
of Mead and Buber. This book, significantly, is entitled Thi 
Social Self. [See, also. Chapter 11.] 

Psychology, Theology, and Social Self 151 

say that such a person is perfect. From time to time, 
even the best of men and women "stumble," "sHp/' or 
momentarily "fall." But they know how to correct their 
errors, how to pick themselves up, redeem themselves. 
I once heard a colored attendant in a mental hospital 
remark to a patient: "The Good Book says, when you 
dowrij don't wallow!" And the psychiatrist, David Levy, 

Fig. 1. A crude attempt to diagram normal and abnormal 
life styles. The top horizontal line, with its occasional imperfec- 
tions or "dips" but essentially straight course {from left to 
right), represents ongoing existence in a normal, emotionally 
and morally healthy individual. When such a person makes a 
mistake, he corrects it and "goes on." But some individuals, 
while pretending to be "on the level," allow themselves to "sink 
\in sin," as shown by the descending, lower line. Because of the 
danger, strain, and self -revulsion involved in such a "double 
life," the individual eventually experiences a crisis {at X); his 
sins "catch up" with him and he is overwhelmed by guilt and 
anxiety. Now his option is a slow, painful "come-back" {as- 
cending line) or further withdrawal from the whole human en- 
terprise {descending broken line), in the form of suicide, 
chronic paranoia, or general deterioration. The diagram could 
perhaps be usefully elaborated to show how some persons, as a 
result of crisis experience, also rise to "new heights." But, as it 
stands, the diagram illustrates the most essential features of 
the present analysis. 

voices the same thought when he says that one of the 
hallmarks of good character and emotional health is 
resiliency, bounce. Therefore, I would modify the straight 
line, as shown in the accompanying figure, so as to pro- 
vide for periodic dips and recoveries, imperfections, dents, 
but not nose dives. 

However, not everyone has the strength of character 
or wisdom to correct his mistakes, promptly and fully. 

152 The Crisis in Psychiatry and Religion 

which means that when he shps he takes a real plunge, 
as shown by the lower line in the figure. Let me suggest 
an illustration. A bank employee needs a little extra 
money for a few weeks. He has access to stacks of cur- 
rency which he knows will not otherwise be used during 
this period so decides to "borrow" some of it, with the 
full intention of replacing it. But his affairs do not move 
as he had hoped, and he is unable to replace the money 
and, in fact, soon finds himself in need of another ''loan." 
And each time he thus illegally helps himself, it becomes 
easier to do so again, the thought of restitution becomes: 
more and more remote — and our friend is soon a con- 
firmed embezzler.^ 

Now for a time things may go smoothly with this 
fellow, and he may even regret his not having adopted 
such a procedure earlier. But he is, of course, in constant 
jeopardy, as indicated by the discrepancy between the top 
line, which is what he pretends to be (namely, an honest 
bank employee), and the bottom line, which represents 
the level to which he himself knows he has sunk. Even- 
tually, of course, something nearly always happens, and 
our embezzler ''gets caught"; that is to say, there is a 
crisiSf which is represented by the large X in the diagram. 
Now the choice, if he has one, is between slow, painful 
repayment or "restitution" (see the ascending line) and 
criminal proceedings, imprisonment, disgrace, and, not 
inconceivably, suicide (descending line). 

Here the crime is a financial and legal one but it 
nevertheless provides a good model for moral defection 
and human "bankruptcy." Mistakes or sins of an inter- 
personal character which are unacknowledged and unre-; 
deemed also involve delinquency and deception; and 
although things may seemingly go nicely for a time, 
something likewise eventually happens which precipitates 
a crisis, but now within the individual's own mind or 
"soul" — and So-and-So, we say, has had a "nervous 

® In a recent study, Cressey (1953) points out that a part 
of the embezzler's "problem" is that it is "unsharable," This 
state of affairs, it seems, characterizes many other situations 
which get human beings into emotional or legal difficulties. It 
is an essential feature of the present argument that no one eva 
goes to prison or to a mental hospital who has (or had) noth- 
ing "to hide." 


Psychology, Theology, and Social Self 153 

breakdown." The fact is, he probably has been down 
for some time, so that we could speak more properly of 
an attack or outbreak of conscience. We say that the 
individual has become mentally ill, emotionally sick, and 
needs "treatment." But it is probably more discerning 
to say that he has been ''sick" for quite some time and 
that what we now perceive as manifest "illness" is really 
an inner revulsion against a duplicitous and disgraceful 
life style and an attempt, as Boisen would say, at correc- 
tion and cure.^ I believe it is not inaccurate to posit 
that virtually all of our contemporary efforts to deal with 
the psychoneuroses are aimed at symptoms, and do not 
get to the real root of the matter, and so remain ineffec- 
tive. Note how often we speak of restoring the individual 
to his former self, when not restoration but reformation 
is what is needed. 

As if at last awakening to the absurdity of this ap- 
■ proach, we are beginning to ask again the question: 
What is the true and ultimate nature of man? We 
were willing, for a time, to accept Freud's dictum that 
man is pre-eminently an animal, an organism, whose 
ultimate destiny and fulfillment rests in his instinctual 
life. This view we now distrust, and are rediscovering 
man's inveterate sociality and morality. Freud said that 
the alienation which is involved in personality disturb- 
ance is between man's conscious mind and his body or, 

° It goes without saying that a person does not necessarily risk 
mental illness when he abandons one set of social and ethical 
standards and drops down to a "lower" level of functioning. If 
a person makes this sort of transition openly, we may say that 
he is a "black sheep" or (in sociological jargon) downward 
mobile; but since his defection is a matter of public knowl- 
edge and carries its own natural and immediate consequences, 
such a person's mental health is not in jeopardy. It is the per- 
son who continues to lay claim to full membership in a group 
whose standards he is secretly disregarding who is prey to "bad 
, conscience" and "mental illness." Also, we should note that 
"recovery" from such a state of affairs is never easy. As the 
diagram illustrates, it is a decidedly "up-hill" business; and it 
is totally unrealistic to encourage such persons, either in the 
\ context of secular psychotherapy or religious conversion, to be- 
I lieve that their "salvation" can be simple and easy. Salvation is, 
nonetheless, possible; and it is our obligation to see and delin- 
eate that possibility clearly and accurately. 

154 The Crisis in Psychiatry and Religion 

in terms of the title of one of his theoretically most 
significant books, between The Ego and the Id. Our 
perception is now changing and we see that the battle- 
ground lies, rather, between the individual and, again to 
quote Boisen, "that social something we call God." 

Over the main entrance to Emerson Hall, which used 
to house psychology and philosophy at Harvard, is en- 
graved the Old Testament query or, more properly, awe- 
inspired exclamation: "What is man that Thou art 
mindful of him?" For a time it looked as if God had 
forgotten us, as we had abandoned and turned away 
from Him. But if it is indeed the Holy Spirit that is 
working in us when we are "disturbed" and "emotion- 
ally sick" [see Chapter 9], then God is very much with 
us, indeed, and it behooves us to seek Him out on 
friendlier terms, that we may be spared knowing Him 
only in His Wrath and Vengeance.^^ 

I hope that none of you will feel that in these lectures 
I am purporting to say anything new or original, except 
in a very superficial and transitory way. One of Harry 
Emerson Fosdick's published sermons is entitled "Redig- 
ging Old Wells." And here Fosdick describes the great 
watering places which the patriarch, Abraham, planned 
and provided at strategic points in Palestine. When the 
Philistines pillaged the land, these wells were despoiled 
and filled; and Abraham's son, Isaac, made it his business 
to re-open the well-springs of his father. Just because 
something is old is no reason to think it is necessarily 
unsound or inferior. Although I hold no brief for the 
metaphysical baggage which the Judeo-Christian Ethic 
has accumulated in the course of 2,000 years, I do main- 
tain that this Ethic embodies some perduring verities 
which we can today ignore only at our deadly peril. 
Surely the author of the 139th Psalm glimpsed the 
eternal when he wrote: 

"It has become unfashionable (see also Chapter 5 to talk 
about the wrath of God. I am indebted to Dr. Elmer Million 
for calling to my attention the statement (by an unidentified 
author) to the effect that the "wrath of God" is the way in 
which those who oppose His will experience His love. The im- 
plications of this way of viewing the matter for child-parent 
relationships and practices are clear and illuminating. 

Psychology, Theology, and Social Self 155 

Whither shall I go from thy spirit? or whither shall I 
flee from thy presence? 

If I ascend up into heaven, thou art there: if I make 
my bed in hell, behold, thou art there. 

If I take the wings of the morning, and dwell in the 
uttermost parts of the sea; 

Even there shall thy hand lead me, and thy right hand 
shall hold me. 

If I say, surely the darkness shall cover me; even the 
night shall be light about me. 

Yea, the darkness hidest not from thee; but the night 
shineth as the day: the darkness and the light are both 
alike to thee. . . . 

Search me, O God, and know my heart: try me, and 
know my thoughts; 

And see if there be any wicked way in me, and lead me 
in the way everlasting. 

And Francis Thompson, in the first stanza of his great 
religious poem, "The Hound of Heaven," puts the same 
thought no less majestically and with peculiar cogency 
for our time, when he says: 

I fled Him, down the nights and down the days; 

I fled Him, down the arches of the years; 
I fled Him down the labyrinthine ways 

Of my own mind; and in the mist of tears 
I hid from Him, and under running laughter. 

Up vistaed hopes I sped; 

And shot, precipited, 
Adown Titanic glooms of chasmed fears, 
From those strong Feet that followed, followed after. 

But with unhurrying chase, 

And umperturbed pace, 
Deliberate speed, majestic instancy, 

They beat — and a Voice beat 

More instant than the Feet — 
"All things betray thee, who betrayest Me." 


Protestant Christianity: 

I. Ambiguity and Disaster* 

The title of Section II of this paper is "The Strange 
Affinity of Protestant Christianity and Freudian Psycho- 
analysis/' which might well serve as a subtitle for the 
paper as a whole. Certainly the traditional precepts of 
Christianity are not such as to lead one to expect a ready 
assimilation of Freudian principles; yet such an assimila- 
tion, astonishingly enough, has occurred — or, perhaps 
more accurately, is being widely promoted. The situation 
is thus extremely perplexing and problematic. Here, in 
the present chapter, an effort is made to understand 
this situation in terms of historical and cultural develop- 
ments which date back at least to the Protestant Refor- 
mation. It may, in fact, not be too bold to conjecture 
that the Reformation, by its deficiencies and anomalies, 
actually produced psychoanalysis. If so, it can be argued 
with some cogency that the only way to extricate our- 
selves from the dead end of Freudianism {see Chapter 
10) is to continue the Reformation. As we shall see in 
the last section of this chapter, there is actually wide- 
spread and growing support for such a program, which 
will be more fully elaborated in Chapter 12. 


There can, I believe, be no reasonable doubt that in 
that area denoted by the terms Psychiatry and Religion, 
we are today in a state of crisis. For the past several 
decades we have been in the habit of saying to anyone 

* Delivered at North Park College and Seminary on May 2 as 
the first of the David Nyvall Lectures for 1960; also presented, 
earlier, at a meeting held in Los Angeles, April 21, 1960, under 
the auspices of the Department of Pastoral Care of the Hospi-: 
tal of the Good Samaritan and later, in September as a Geehns 
Lecture at the Southern Baptist Theological Seminary, in 
Louisville, Kentucky. 


Protestantism: i. Ambiguity and Disaster 157 

who is in emotional difficulties, "You need therapy.'^ 
But now we are realizing that our so-called therapy is 
itself sick and needs ''therapy" (cf. Chapter 10). As 
long as we continue to believe that all is well in this 
area and that all we need is more of the same, just 
so long will we continue to spiral downward in a vicious 
circle which, as Richard LaPiere (1959), Huston Smith 
(1960), and others are suggesting, is bringing our very 
civilization and established way of life into jeopardy. 

Personality disorder of sufficient severity to require 
hospitalization is today commonly acknowledged as the 
nation's number-one "health problem"; and the preva- 
lence of divorce, delinquency, suicide, perversion, and 
addiction of various kinds — including the habitual use of 
alcohol, tobacco, and various other tranquilizers — ^be- 
speaks the widespread tensions and poor personality 
integration in the populace at large. 

Religion, to which we have traditionally looked for 
redemption from evil and guidance in the good life has 
all but abandoned its claim to competence in these 
matters. To be sure, in recent decades there has been an 
attempt, in the guise of the pastoral counseling move- 
ment, to regain lost ground; but here the dominant ideas 
bave been essentially secular; and when clergymen them- 
selves have serious personality problems, they almost 
invariably seek a secular therapist rather than depend 
upon inspiration and direction from within their own 
profession. On several occasions I have made the state- 
ment that contemporary Protestantism has handled the 
problem of personal guilt very poorly; and it is, 1 think, 
tio accident that this assertion has not been seriously 
challenged. For as long as Protestant clergymen preach 
the Christian gospel on Sundays and then, on weekdays, 
lave recourse to secular psychotherapists for help in the 
management of their own lives, their message will have 
ittle force or effect in stemming the tide of personal and 
social disorganization in our time. As Anton T. Boisen 
iDbserved more than 30 years ago, most Protestant reli- 
i;ious leaders have allowed themselves to drift into a 
bosition from which they can speak only as the scribes 
pd Pharisees, not with authenticity and authority (see 
Chapter 6). They proclaim certain tenets of Protestant 

158 The Crisis in Psychiatry and Religion 

doctrine, particularly of a Calvinist stripe, from their 
pulpits, but seem completely unimpressed that this doc- 
trine is not saving thertiy much less the persons to whom 
they ostensibly minister. They preach justification by 
faith and roundly condemn "good works," and seemingly 
take no account of how poorly this doctrine itself works, 
in the lives of modern men and women. 

In August, 1956, a story appeared in Life Magazine 
on "Why More and More Ministers Crack Up," ini 
which the author maintained that the trouble lies simply 
in overwork. Modern churches, he argued, make exces-i 
sive demands of their ministers; and the solution sug-' 
gested was for all churches of more than 500 members 
to have two or more ministers, with a clearly defined 
division of labor. While this is no doubt a good prac- 
tical suggestion, it does not, I believe, get to the root of 
the difficulty. The trouble basically is that the modern 
clergyman is in an ambiguous and agonizing situation: 
pretending to minister the Bread of Life to others and: 
having no deep trust in it himself. 

Here the inconsistency of the clergy is equalled only 
by the audacity of the secular therapists to whom they 
turn, not only for personal guidance but also for intel- 
lectual inspiration and enlightenment. Although it has 
been evident for at least 20 years that classical Freudian 
psychoanalysis is a therapeutic fiasco, yet the assumptions 
concerning the nature of man from which this form of 
treatment was derived continue to be acclaimed as if 
one could move the world with them. I don't know 
how often, when I have criticized psychoanalysis, the 
protest has come back: "But isn't it true that the super- 
ego is overly severe in the neurotic individual and needs 
to be softened, made less harsh and demanding?" It is? 
true that this is what Freud saidy and a lot of people^ 
have tried to believe and apply this doctrine. But it is 
public knowledge that both therapy and prevention! 
which are based on this premise lead only to the most 
dismal consequences; and one might suppose it wast 
time that we stopped, for purely pragmatic reasons^ 
accepting the premise itself. If it doesn't work^ what is 
there to make us think it is true, especially when it 
contradicts some of the most basic principles of the 
Judeo-Christian ethic? 

Protestantism: i. Ambiguity and Disaster 159 

ii. the strange affinity 
of protestant christianity 
and freudian psychoanalysis 

For a long time it was a mystery to me why Protes- 
tantism and Freudian psychoanalysis have hit it off so 
well. In many ways they are very strange bedfellows 
indeed. The New Testament, to say nothing of the Old, 
seems fairly to cry out in opposition to everything which 
psychoanalysis stands for; and Freud, in his book. The 
Future of an Illusion, made his opposition to and con- 
tempt for religion crystal clear [cf. Chapter 9]. Yet 
present-day Protestantism and Freudian analysis are so 
blended and interdigitated that it is hard to tell where 
one ends and the other begins. 

The total explanation of this astonishing state of 
affairs is, I am sure, complicated. But do we not find 
food for thought in the fact that both Protestantism, 
insofar as it is Calvinistic, and the secular psychothera- 
peutic enterprise, insofar as it is Freudian, equally stress 
the helplessness of man? Calvin saddled us with the 
doctrine of predestination and divine election; and Freud 
spoke of psychic determinism and the tyranny of the 
unconscious. Both would have us believe that we are 
totally incapable of helping ourselves; and they differ 
principally in the extent to which they hold us account- 
able for the distressing predicaments in which we com- 
monly find ourselves. 

Protestantism has been curiously one-sided in its argu- 
ment on this score. While holding that when we behave 
badly it is by our own volition and choice, it then insists, 
paradoxically, that when we behave well this is by the 
grace of God, for which we deserve no credit. In other 
words, the doctrine is that when we are confronted by 
an apparent option of good and evil, we can choose 
only the evil, and are fully accountable for having done 
so; but if we do the good rather than the evil, this is 
because of God's will and direction. In short, man can 
willfully and deliberately act and work himself into a 
state of perdition; but he cannot, by the reverse strategy, 
save or redeem himself. Salvation comes, if it comes at 
all, only by the grace and unpredictable favor of God. 

160 The Crisis in Psychiatry and Religion 

Small wonder, then, that such a doctrine leads to the 
condition of uncertainty and ''despair" about which Soren i 
Kierkegaard has written so poignantly in his Sickness \ 
unto Death and Attack upon Christendom. And it is, Ii 
submit, this same despair that fostered the development! 
and growth of Freudian psychoanalysis; for psychoanalysis \ 
takes the further step of making man irresponsible andi 
unaccountable, not only for his salvation, but also for 
his sins as well. 

According to Freud the neurotic individual is helpless, 
because certain of his problems have been relegated toi 
and lost within the Unconscious Mind. But Freud was 
at least more consistent and, in one sense, more benign. 
Unlike Calvin, he held the individual accountable neither 
for his salvation nor for his sin. As a child, the individual 
who is destined to be neurotic as an adult, has sup- 
posedly been so harshly and unreasonably treated by his 
parents that he has no alternative but to repress certain 
impulses, certain instincts; and it is this act of repression 
or dissociation which lays the basis, according to Freud, 
for that special misery called neurosis. Thus psycho- 
analysis goes Protestant theology one better and makes 
us not only unable to help ourselves in the matter of 
"'recovery" but also blameless, and unaccountable, for 
having gotten ourselves into our "neurotic predicament* 
in the first place. 

It is, therefore, not surprising that so many Protestant 
clergymen, as well as the members of their congrega- 
tions, have flocked to secular psychotherapists for "help." 
The analyst not only gives a more definite promise of 
salvation; he also holds us less "to blame" for our diffi- 
culties. Calvinist Protestantism has said to us: "You are 
responsible for your sins, but you are incapable of being 
equally responsible for your redemption. God condemns 
you for your evil, but He will pay no attention to your 
own efforts to redeem yourself and will Himself save 
you or not, according to His inscrutable pleasure." This,* 
I submit, is a psychological and human absurdity and a 
Christian deviation and perversity. But instead of rectify- 
ing this perversity, we have compounded it by plunging 
into psychoanalysis, which extends the heresy to its. 
logical limits and takes away our responsibility, choice^i 


id freedom not only with respect to our salvation but 
so for our sin as well. 


On other occasions I have documented the statement 
lat there is not a shred of evidence that psychoana- 
zed individuals permanently benefit from the experience 
Chapters 1, 9, and 14]; and there are equally clear 
dications that psychoanalysis, as a common philosophy 
' life, is not only nontherapeutic but actively pernicious, 
ere I shall not attempt to review the objective evidence 
it will speak instead about the reactions of a psychiatrist 
ith whom I recently had considerable contact at a 
lall, intensive three-day conference. His position was, 

effect, this. Yes, he agreed that psychoanalysis is un- 
tisfactory. He had been trained in it, had applied it, 
id could not make it work successfully and so had 
landoned it for a different form of practice, for which 
! had higher hopes. He could not, he admitted, prove 

yet that his approach was superior to that of Freud; 
it, he said, "people keep coming to you and you have 
do something." And what precisely was this something 
lich he was doing? 

It turned out that his deviation from Freud consists 
:gely in the fact that he does not require his patients 

lie on a couch and does not observe certain other 
-called "technical rules" of analysis; but he is still 
vocating the basic Freudian premise that in neurosis 
/hich I hold is just a medical euphemism for a state 

unacknowledged and unredeemed real guilt), the 
dividual is blaming and punishing himself quite un- 
cessarily. As we grow up, this psychiatrist said, "we 
come our own parents," which was his way of para- 
irasing the Freudian notion that the conscience or 
perego is an incorporation or introjection of our par- 
ts' standards and values. And then he added, "We 
ow the injustices to which we were subjected back 
ere in our family. We know what the atmosphere in 
r home was like. And yet we insist upon treating our- 
ives, as adults, in the same harsh and unreasonable 
ly our parents treated us as children." 

162? The Crisis in Psychiatry and Religion 

In insisting that our children develop a sense of guil 
and the capacity to blame themselves, we pave the wa 
for neurosis, according to this psychiatrist. And by sup 
porting this kind of child training, the churches, he said 
"are propagating a most vicious kind of mental ill healtV, 
The churches create this type of attitude in people, an.] 
I get the sweepings from it. I'm tired of seeing religiouj 
parents and the churches teach children to tramp oi 
themselves and would like to see this group take a; 
official stand against such practices." We are ''divine, 
the psychiatrist argued, and we have no right to tre£ 
ourselves in this way. And he blamed religious institi 
tions for teaching a doctrine of sin, and guilt, and sel 
condemnation instead of a doctrine of self-love, sel 
forgiveness, and self-acceptance. 

How unrealistic can we get? Conscience, that is to S£ 
the capacity for self-blame and self-punishment, is ( 
marvelous human and social invention, which has tl 
highly adaptive function of causing us to "tramp c 
ourselves" in order that others don't have to do th 
for us. I know not a single reputable sociologist f 
anthropologist who would seriously maintain that v 
can have a society which does not internalize, as th 
would say, the norms of the culture (Mowrer, 1961 
Otherwise we have, not a society, not an organize 
disciplined, orderly group, but an aggregate of psych 
paths or, more accurately, sociopaths. And this is pi 
cisely the direction in which classical psychoanalyl 
theory and treatment and the so-called psychotherapeul 
enterprise in general have been pushing us and the dire 
tion in which we are actually moving. Was it not the ve 
fact that the individuals involved in the 1959 televisi< 
quiz-show scandals did not "tramp on themselves" th 
permitted them to act as they did? This is only one] 
dozens of similar illustrations of what happens whi 
human beings refuse to "be their own parents" and 
act as responsibly in their adult life as their parents tri 
to teach them to act as children. 

As indicated in the preceding section of this pap 
Calvinist Protestantism took the first major step tow£ 
that brand of personal irresponsibility which is sociopatl 
by making us supposedly powerless to do anything C( 
structive about our guilt and sin; and then psychoanal}! 

Protestantism: i. Ambiguity and Disaster 163 

:ame along and took us the rest of the way by insisting 
:hat not only can we not help ourselves move toward 
:ecovery; we are wrong to blame or punish ourselves in 
:he first place. We should love and accept and respect 
Durselves so perfectly and so completely and so uncondi- 
;ionally that we refuse to condemn, punish, "tramp on" 
}urselves, no matter what! This, I submit, is not self- 
respect. This is the ultimate in self-contempt and rejec- 
don! For it requires us to regard ourselves, not as human 
)eings, but as a variety of organism not basically different 
TOm the beasts of field and jungle, with no morality, no 
itandards, no character, no spirit. Who wants to lose his 
Capacity to condemn and punish himself if he really 
pehaves badly. This, surely, is the Pearl of Great Price; 
md a so-called "therapist" who would take it from us 
toes not respect us but despises us, himself, and the 
vhole human enterprise. It is true, of course, that if we 
lid not have the capacity for self-condemnation and self- 
mnishment, we would never be neurotic or functionally 
jsychotic, but neither can we be human without such 
apacity. As Boisen (1936) has observed, susceptibility 
this anguish is the price we pay, the risk we take, for 
tur efforts to be something more than vegetables and 
)easts. This is why I have said on other occasions [Chap- 
ers 9 and 14] that psychoanalysis is not messianic but 
iemonic, not salvation but slavery and bondage of the 
/orst kind. 


Following a lecture which I gave recently at the Uni- 
ersity of California at Los Angeles [March 7, 1960], 
)r. D. P. Boder made some extemporaneous comments 
hich I found extremely illuminating and which I believe 

can reproduce almost verbatim. He said: 

The Freudian theory of emotional sickness and its treat- 
ment is a direct outgrowth of the writings of the 19th-cen- 
tury German nihilistic philosophers. Nietzsche, particularly 
in his book The Genealogy of Morals, repeatedly affirms that 
guilt is a weakness. And the poet Schiller, in his play, The 
Bride of Massina, has the chorus end the play by speaking 
these lines: 

164 The Crisis in Psychiatry ai^ Religion 

Life may not be the highest possession. 

But guilt is the greatest evil. ! 

Since Protestant Christianity instills in us the capacity 
to experience guilt but with no personal resource 05 
reliable possibility for alleviating it, we can see why mer: 
of intelligence and vitality began to think and utter such 
outrageous ideas. And Freud, far from saving us frorr 
this rebellion and despair, perfected and systematized it| 
Today we are paying the price for having accepted this 

You will, I hope, realize that here I am speaking in j 
highly generalized way. There are, perhaps, a few psy 
chotherapists here and there who are practicing thei 
profession along lines radically different from those lai( 
down by Freud. But they have not as yet become ver 
articulate in the professional literature and it is hard t(. 
identify them. There are, of course, plenty of therapist 
who are purportedly non-Freudian; but the majority o 
these, I fear, are like the psychiatrist whom I cited earlier, 
because they have abandoned classical Freudian tech 
nique or some minor aspect of the theory, they cat 
themselves non-Freudian, or neo-Freudian, or perhap 
even anti-Freudian while continuing to accept the majo 
premises of Freud's philosophy and thought. 

The nondirective or client-centered type of therap; 
which is associated with the name of Carl Rogers will 
of course, be immediately thought of by many as "non 
Freudian." But as I am here using the term, I woulc 
say that Roger's approach is deeply "Freudian" (cf 
Youngs, 1960). Like classical psychoanalysis, it begin 
by not holding the individual personally responsible fo 
his difficulties and gives him no prescription for dealinj 
with them on his own initiative. Rogers views the in 
dividual as inherently good and holds that he is coi 
rupted and diverted from his indigenous growth ten 
dencies along normal and healthy lines by the untowan 
actions and attitudes of those around him. Here the en 
couragement of self-pitying and hostile tendencies withii 
the client is hardly less direct than it is in psychoanalysis 
And although Rogers (1951) has seemed not to accep 
Freud's doctrine of repression, he speaks of the ''denia 
of experience" which, operationally, is not easily differen 

Protestantism: i. Ambiguity and Disaster 165 

tiated from dissociation or repression, thus re-afErming 
the doctrine of the Unconscious and the individual's 
essential helplessness with respect to it. I understand 
from others who have recently worked with Dr. Rogers 
that his views are in process of being revised; but as of 
his best known and most recent public utterances, I 
believe this appraisal is a reasonable and accurate one. 

It can, of course, be objected that my strictures against 
Protestantism are likewise not universally applicable. And 
here the argument may take either of two directions. 
Some will insist that I do not understand what Calvin 
"really meant." Although I think I have a fair concep- 
tion of what Calvin stood for (cf. Gilkey, 1960), I must 
confess that I am not greatly concerned about the under- 
standing of Calvin himself. What is important for our 
purpose is the widespread popular conception of what he 
meant; and I am therefore using "Calvinism" in much 
the same way as I am "Freudianism." I can myself quote 
excerpts from Freud's writings which seem categorically 
to contradict the general position here (and popularly) 
attributed to him. But the important thing is the main 
thrust and impact of the thought of these men; and if 
this does not in all details correspond to precisely what 
they said (especially toward the latter periods of their 
lives, when they had had a chance to reconsider a bit), 
this does not particularly matter. We are concerned here 
ivith cultural forces, and the very fact that I have chosen 
to deal with both Freudianism and Calvinism as they are 
bopularly understood is consistent with this aim and goal. 

The second of the two types of objection referred to 
I moment ago is this, namely, there are certain Funda- 
nentalist or "sect" groups within the Protestant spectrum 
vho have not "fallen" for Freudianism to the extent that 
iberal Protestantism has. This I readily grant; but at 
3nce we have to make a distinction between those groups 
vhich are explicitly Calvinistic and those which are 
iecidedly not. The Calvinistic sect groups are in much 
he same position as was Protestantism in general before 
he advent of liberalism and the infiltration of Freudian- 
sm. They leave man with his guilt and do not attempt 
:o deliver him from his "despair" by the Freudian for- 
mula of making him not only helpless but also blameless, 
pliey are thus, in one sense at least, in a sounder posi- 

166 The Crisis in Psychiatry and Religion 

tion than are the hberal Protestant groups and have, one 
may say, less to repent. But they are still on the horns; 
of the dilemma which Calvinism itself poses and do not 
offer a satisfactory resting place. ! 

In contrast, there are some so-called sect groups whichi 
preach and practice a form of Christian doctrine whichi 
seems to me remarkably close to primitive Christianity 
and which has been remarkably little affected by the 
more dubious aspects of the Reformation, Later we shall) 
have occasion to look again, more closely, at these groups,i 
at the same time that we also consider the place ofi 
Roman Catholicism and Judaism in the modern world? 
[Chapter 12]. First, however, it will be necessary toi 
review certain other considerations of a somewhat differ-* 
ent nature. 


Before one can have anything like an adequate under-: 
standing of the present crisis in psychiatry and religion,! 
one must, I believe, carefully note the extent to which 
numerous functions which prior to the Reformation were 
regarded as the proper concern of the Church have 
today been secularized. The Reformation was a valiant 
effort to free mankind from the oppressive control and 
domination previously exercised by the Church Universal. 
And separation of Church and State, in as many areas- 
as possible, was seen as basic to this enterprise. 

Separation of Church and State in the area of politics 
was, of course, a prime objective of the Reformation; and 
we still have a strong feeling that religious groups should 
"stay out" of politics, at least in the formal sense of the 
term. Education has likewise been extensively secularized. 
Our public schools are testimony to the success of this 
movement, even though there is still resistance in some 
quarters, both in theory and practice. The trend toward 
secularization has also been marked in the area of charity. 
Here we note the widespread development of public 
relief, as well as numerous welfare agencies of a private 
but, again, largly secular nature. The introduction of 
insurance of various kinds has had a similar effect in this 
connection: now, instead of giving directly to persons 
who have suffered physical calamity, such as loss oi 

Protestantism: i. Ambiguity and Disaster 167 

lome by fire or flood, or incapacitating illness or death 
n their family, we pay regular ''premiums" to a company 
vhich carries out these functions, quite automatically 
md impersonally, for us. 

In these areas, then — of politics, education, and charity 
—it looks as if separation of church and state, in some 
legree at least, is here to stay. We shall later [Chapter 
[2] have occasion to examine some of the less fortunate 
consequences of the secularization of charity; and there 
ire also those who point to evils that arise in public 
education. But, by and large, the gains seem to exceed 
he losses — at least this is the way the situation is popu- 
arly perceived; and there is no strong inclination for our 
ociety as a whole to revert to the earlier condition of 
;hurch control in these areas. 

There is, however, another area in which secularization 
las occurred, with results which are far from satisfactory 
)r reassuring. I refer to the management of the problem 
)f personal guilt. Traditionally the solution to this prob- 
em has rested very largely in the hands of the church; 
md although Protestant and Catholic leaders alike con- 
inue to lay claim to interest and competence in this 
irea, the fact is that those persons who are most deeply 
)urdened and broken by guilt and moral failure are now 
[uite regularly turned over by the churches to the state 
or "care and treatment." This statement, to be sure, 
nvolves an assumption, namely, that in so-called men- 
al illness or psychopathology the central problem is 
;uilt, unconfessed and unatoned real guilt; but elsewhere 
Chapters 3, 4, 5, 7, 8, 10, 14] I have assembled so much 
evidence for believing this assumption to be justified 
hat here I propose to take it for granted. On other 
)ccasions [Chapters 9 and 10] I have also cited extensive 
ividence for the assertion that the state mental hospital, 
\s a therapeutic agency, is a failure and that the time 
b upon us for re-thinking the whole attempt to help guilt- 
idden persons in a secular, medically controlled setting. 
I The phenomenon of legal guilt is manifestly a state 
|esponsibility and probably should remain so, at least 
nsofar as the determination of responsibility for specific 
-Cts is concerned. But here again there is question as to 
he success of the state's efforts at treatment and rehabili- 
ation. Legally, retribution is the principal instrument of 

168 The Crisis in Psychiatry and Religion 

''justice," and as a deterrent to crime on the part of 
others, it may be quite essential; but there is widespread' 
disillusionment regarding its redemptive powers, and, 
such writers as Albert Eglash (1958, 1959) are now sugi 
gesting that prison programs ought to proceed muchi 
more along lines of restitution rather than retribution.| 

It appears, then, that secular, state-directed efforts tc; 
rehabilitate guilty people — ^both those who have been, 
legally adjudged guilty (i.e., criminals) and those who 
(as Boisen has said) are seZ/-condemned (i.e., the insane) 
— ^leave much to be desired. In both areas there has 
been a widespread attempt, particularly under medical 
aegis, to eliminate the whole notion of moral involve- 
ment and to treat both groups as if they were sick. The 
result is that we are now beginning to talk about our 
whole society being "sick," and I have elsewhere sug- 
gested [Chapter 10] that the essence of this "sickness" 
is the undue extension into these areas of the sickness 
concept itself. 

But there is another side of this problem which is quite 
as important as the one we have just been considering. 
Religion, as an institution, can very possibly survive 
without having a direct role in politics, or in education, 
or perhaps even in charity in the material sense of that 
term; but there is grave question as to whether religion 
can survive, i.e., remain vital and meaningful, if it simi- 
larly relinquishes its responsibility for ministering to those 
who are devastated by personal guilt. I have previously 
argued [Chapters 6, 7, 8], as Anton Boisen has done 
for the past thirty-five years, that the church loses its 
very excuse for existence and cuts itself off from essential 
sources of inspiration and validation as soon as it refuses 
to go "all the way" with the person who is in that emo- 
tional and moral crisis which we call neurosis and psycho- 
sis. As soon as the church turns such a person over to 
some other agency or profession to deal with, it signs 
and seals its own death warrant. 

This view of the situation was brought home to me 
with special cogency and force recently when I heard 
a young minister use a purely hypothetical human situa- 
tion to illustrate a point in theology, in a group where 
a psychiatrist who was present was promptly able to cite 
a real, flesh-and-blood "case" to the contrary. Boisen has 

Protestantism: i. Ambiguity and Disaster 169 

long pleaded with ministers and theologians to put their 
books away for a season and to study those ''human docu- 
ments" one finds in what he also colorfully calls "the 
wilderness of the lost." This is not a great innovation or 
departure for Judeo-Christianity; instead it is a challenge 
to the churches to return to a depth of ministry which 
they have generally abandoned. In the parable of the 
lost sheep, Christ tells of the good shepherd leaving the 
ninety and nine that are safely in the fold and going 
to look for the one that has gone astray (Matt. 18:10). 
Is it not the very fact that the modern church has become 
indifferent to lost souls that has reduced its vitality and 
authenticity almost to the vanishing point? As long as 
ministers, priests, and rabbis are impelled and compelled 
to "refer" and defer to psychologists and psychiatrists 
when members of their congregations meet severe per- 
sonal crises, just so long will they find themselves in the 
predicaments described earlier in this paper. 

Recently a college student, in a group where this 
matter was under discussion, epitomized the situation 
admirably as follows. She said: "Because the church has 
refused to go after the one lost sheep, we now find that 
we are all 'lost,' confused, neurotic." 


I cannot claim to be at all fully informed regarding 
contemporary trends in Protestant theology, but my cas- 
ual impression here is of a land of shifting sands. Vogues 
and fashions there are in abundance, but I fail to see 
anything that looks much like the bedrock of perduring 
human realities. One writer, by unusual eloquence, force, 
or novelty, will gain a following, only to be superseded 
by someone else who outdoes him at his own tricks. Just 
at the moment Professor Paul Tillich is in the limelight. 
I am not competent to judge much of what he has 
written; but in the one area where I have some claim to 
specialized knowledge I find him thoroughly ambiguous. 
Take, for example, this passage from a recent sermon 
entitled "The Good I Will, I Do Not": 

In pulpits, Sunday schools and families, Christians have 
called sinful the natural strivings of the living, growing and 
self-propagating body. They concentrate in an inordinate, 

170 The Crisis in Psychiatry and Religion 

purely pagan way on the sexual differentiation of all life and 
its possible distortions. Certainly, these distortions are as real 
as the distortions of our spiritual life, for instance, pride and 
indifference. But it is itself a distortion if the power of Sin 
is seen in the sexual power of life as such. In this way, such 
preaching completely misses the image of Sin as Paul depicted 
it. What is worse, it produces in countless persons a distorted 
guilt feeling which drives from doubt to anxiety, and from 
anxiety to despair, and from despair to the escape into mental 
illness and the desire to destroy oneself (p. 22). 

What, precisely, is Tillich saying here? As is so typical 
of many of his writings, this passage contains a number 
of vague allusions and obscurities. But what Tillich seems 
to be saying here, and over and over again in many other 
places, is this: The Protestant church has given us an 
acute capacity to feel guilt, quite unrealistically, with no 
adequate means of resolving it. Therefore, with the Freu- 
dians, he is suggesting that we reject guilt at its source 
and thus not have to deal with it. Guilt, much of it 
religiously inspired, he says, with Kierkegaard, Neitzsche, 
Schiller, and Freud, is our sickness. In a recent letter 
to a mutual friend, another distinguished seminary pro- 
fessor takes a very different point of view. He says: "In 
so far as Christians have fallen for the notion that guilt 
is a sickness they have made theological donkeys of them- 
selves. Much as I love and respect [Harry Emerson] Fos- 
dick, I suspect he and others of his persuasion got them- 
selves quite mixed up about *sin.' '* 

Here, surely, is a hopeful note, but it is not in the 
ascendancy today. It is not the vogue of the moment. 
Today there are literally thousands of ministers who are 
under the spell of Tillich, Fosdick, and the other Freu- 
dian apologists. And what is the basis on which ministers 
accept the leadership of such men? Is it because psycho- 
analysis has been empirically validated? Not in the least. 
It is rather because theology, by becoming bookish and 
unredemptive, has lost its true center of gravity, its con- 
tact with basic human realities, and its leaders bob about 
like loose corks in a choppy sea. They turn to Freud 
because they have lost their own integrity and anchorage. 
If religious leaders had been deeply involved in the care 
and redemption of seriously disturbed persons for the 
past century, instead of systematically "referring" such 

Protestantism: i. Ambiguity and Disaster 171 

persons, there would have been no Freud and no neces- 
sity for a Tilhch or a Fosdick to try to legitimize him! 

Recently, at the conference to which I have previously 
alluded, I heard seminar professors and distinguished 
parish ministers make statements such as these: ''Today 
pulpit theology is a bunch of words." ''Theology comes 
between us and people." "The minister has trouble get- 
ting his person and his profession together." "The church 
must find a new form for its message." 

I submit that the prime reason for this distressing state 
of affairs is the fact that theology, i.e., the science and 
art in which many of our ministers are trained, is un- 
disciplined verbiage. By what operations is it validated, 
tested, refined, clarified? What are the canons of evi- 
dence which a minister uses for deciding what to preach 
or write about? What are the rules according to which 
he decides what is truth and what is error? Granted that 
this is at best a difficult area in which to be wise, the 
minister who merely reads, preaches, and perhaps does 
a little pastoral counseling with carefully selected cases 
can hardly be expected to have deep insights and to 
inspire great confidence. 

Challenge a parish minister or seminary professor to 
stay with, rather than "refer," a person suffering from a 
severe personality crisis, and what is the typical rejoinder: 
"But Fm not qualified for that sort of thing!" The fact 
is, such a minister is not qualified. Because the church 
does not concern itself with the one genuinely lost sheep, 
the whole congregation is eventually lost; and the min- 
ister himself goes into "therapy" with the same would-be 
secular healers to whom he has been referring others. 
Today's clergyman can, I maintain, save himself only by 
the radical expedient of returning to the full-fledged 
business of saving, rescuing, redeeming others. And when 
he does this, pulpit "theology" will recover the substance 
and stability which are today so conspicuously lacking. 
Here is one function which cannot be secularized, with- 
out calamity to all concerned. 


Ladies and Gentlemen, I must acknowledge at this 
juncture the surprise and, indeed, embarrassment I feel 

172 The Crisis in Psychiatry and Religion 

at finding myself, as a psychologist, playing the role of 
theological and religious analyst and critic. The presump- 
tion thus involved is, of course, enormous; and I venture 
upon such a course only after having become persuaded 
that the contemporary psychotherapeutic enterprise, and 
its vagaries, cannot be understood without examining the 
theological situation, in both its contemporary and his- 
torical dimensions. Even so, if there were absolutely no 
precedent among more competent scholars for the type 
of reservations and concerns I am expressing, I might 
still lack the necessary audacity to enter into such a 
discussion. But the fact is, one finds considerable support 
for this sort of thinking in the works of some of the most 
distinguished theological writers of this generation. 

In February of 1960, it was my privilege to hear the 
lectures, on "The Christian Faith and Historical Think- 
ing," which Dr. Wilhelm Pauck, Professor of Church 
History at Union Theological Seminary, gave at the I 
Pastoral Conference sponsored by the Pacific School of i 
Religion, in Berkeley, California. Here Dr. Pauck re-i 
minded his audience that the leaders of the Reformation ■ 
were of a decidedly medieval stamp of mind, and that; 
their insights and truths are not necessarily pertinent or 
applicable in our time. He pointed out that as a result of 
this hiatus, "Christianity has become a minority move-j 
ment" in the modern world and stoutly maintained that ! 
"The Reformation must go on." i 

Almost immediately afterward, in the Christian Ccn-j 
tury for March 2, Professor H. Richard Niebuhr, of the i 
Yale Divinity School, published an article entitled, "Ref- j 
ormation: Continuing Imperative." The first part of i 
this paper is largely autobiographical and not particularly ' 
pertinent to our interests; but the later part is highly so i 
and will be quoted at some length. 

My primary purpose today is not to protest. It is still 
that of the reformation of the church. I still believe that I 
reformation is a permanent movement, that metanoia is the | 
continuous demand made on us in historical life. The im- 1 
mediate reformation of the church that I pray for, look for j 
and want to work for in the time that may remain to me 
is its reformation not now by separation from the world but 
by a new entrance into it without conformity to it. I believe 
our separation has gone far enough and that now we must 

Protestantism: i. Ambiguity and Disaster 173 

find new ways of doing what we were created to do. One side 
of the situation is that represented by the "world" today, at 
least the Western world. It seems to me that in that world 
men have become deeply disillusioned about themselves and 
are becoming disillusioned about their idols — the nations, 
the spirit of technological civilization and so on. They no 
longer expect the powers in them or around them to save 
them from destruction (whether through holocaust or bore- 
dom) or from the trivialization of an existence that might 
as well not have been. The so-called underdeveloped nations 
— including Russia — do not yet know that there is no hope 
and no glory and no joy in the multiplications of our powers 
over nature, and we have no way of saving them from going 
through the experience through which we have passed or are 
passing. But in the West the most sensitive, if not yet most, 
men are living in a great religious void; their half-gods have 
gone and the gods have not arrived. The religious revival we 
are said to have had in recent years has been, so far as I can 
see, less a revival of faith in God and of the hope of glory 
than a revival of desire for faith and of a hope for hope. 
And it further seems to me that our churches have been filled 
(our seminaries too) with men and women who are experi- 
encing that emptiness; further, that there is in the society at 
large a host of similarly minded persons who have not even 
considered the church as possibly ministering to their need. 
I am haunted in the presence of that situation by the phrase: 
*'the hungry sheep look up and are not fed" (p. 250). 

Professor Niebuhr then calls for a "resymbolization 
of the message and the life of faith in the One God" 
and concludes by saying: 

I do not know how this resymbolization in pregnant words 
and in symbolic deeds (like the new words of the Reforma- 
tion and the Puritan movement and the Great Awakening, 
like the symbolic deeds of the Franciscans and the social 
gospelers) will come about. I do count on the Holy Spirit 
and I believe that the words and the deeds will come about. 
I also believe, with both the prophets and, of all men, Karl 
Marx, that the reformation of religion is the fundamental 
reformation of society. And I believe that nothing very im- 
portant for mankind will happen as a result of our "conquest" 
of space or as a result of the cessation of the cold war unless 
the human spirit is revived within itself (p. 251). 

Such statements as those just quoted from Niebuhr 
and Pauck not only underscore the general shakiness of 
contemporary theology; they are also an open invitation 

174 The Crisis in Psychiatry and Religion 

to rethink our most fundamental presuppositions. But 
they do not give us any very confident or clear indication 
of the direction such thinking should take. Turning to 
Tillich's book, The Protestant Era, a collection of essays 
first issued in 1948 and reissued, in abridged form, in 
1957, one finds little help in the earlier chapters; but 
the book ends with a paper, initially published in 1939 
in the American Journal of Sociology and entitled, 'The 
End of the Protestant Era?" which is hard-hitting, direct, 
and — up to a point — illuminating. The argument begins 

The central principle of Protestantism is the doctrine of 
justification by grace alone, which means that no individual 
and no human group can claim a divine dignity for its moral 
achievements, for its sacramental power, for its sanctity, or 
for its doctrine. If, consciously or unconsciously, they make 
such a claim, Protestantism requires that they be challenged 
by the prophetic protest, which gives God alone absoluteness 
and sanctity and denies every claim of human pride. This 
protest against itself on the basis of an experience of God's 
majesty constitutes the Protestant principle. This principle 
holds for Lutheranism as well as for Calvinism and even for 
modern Protestant denominationalism. It is the principle 
which made the accidental name "Protestant" an essential 
and symbolic name (p. 226). 

And then Tillich says: 

The consequences of the Protestant principle for intellec- 
tual, moral, and social life are obvious. Protestantism is a 
highly intellectualized religion. The minister's gown of today 
is the professor's gown of the Middle Ages, symbolizing the 
fact that the theological faculties as the interpreters of the 
Bible became the ultimate authority in the Protestant 
churches. But professors are intellectual authorities — i.e., 
authorities by virtue of skill in logical and scientific argu- 
ment. This sort of authority is the exact opposite of the 
kind that is sought by the disintegrated masses, whose dis- 
integration is to some extent an echo of the endless argu- 
ments and counterarguments among their leaders. Bishops, 
priests, and monarchs have a sacramental authority which 
cannot be taken away by arguments and which is independ- 
ent of the intellectual and moral qualities of its carriers. It 
is a character which can by no means be lost. This sacra- 
mental basis is denied by the Protestant protest. The minister 
is preacher, not priest; and sermons are intended, first of all, 
to appeal to the intellect. But the masses that are dis- 

Protestantism: i. Ambiguity and Disaster 175 

integrated need symbols that are immediately understand- 
able without the mediation of intellect. They need sacred 
objectivities beyond the subjective quality of a preacher. . . . 
More and more individuals become unable to endure the 
tremendous responsibility of permanently having to decide in 
intellectual and moral issues. The weight of this responsibil- 
ity became so heavy that they could not endure it; and men- 
tal diseases have become epidemic in the United States as 
well as in Europe. In this situation, psychoanalysis has 
seemed more desirable for educated people than religion, 
especially Protestant religion. In Catholic countries the situa- 
tion has been different because the confession has been able 
to overcome many tendencies toward personal disintegration 
(pp. 227-228). 

Then, in a footnote, Tillich refers to the "success of 
psychoanalysis in Protestant countries" which he at- 
tributes to the assistance it gives the individual to ''bear 
responsibility and guilt without the help of confession 
and the related forgiveness which comes from the out- 
side" (p. 228) . Here, it would seem, is where Paul Tillich 
took the wrong turn in the road. Today we can say, 
without fear of contradiction, that psychoanalysis has not 
been a "success," in this or any other country. Yet many 
theologians, including Tillich, continue to preach and 
write as if Freudian theory and practice were the Alpha 
and Omega. When, as in the Tillich sermon cited in the 
preceding section, theologians today expound the psycho- 
analytic doctrine of false guilt, they simply do not, from 
a secular and scientific point of view, know what they 
are talking about. This, among other reasons, is why I 
say that secular students of this problem have no choice, 
at the moment, but to strike out on their own in this 
domain and make the best sense of it they can. And the 
only way the present writer can understand the situation 
is along lines suggested at the outset of this paper, 
namely, in terms of the absurdity of the Reformation 
doctrine of human guilt and divine grace. This, as I have 
already argued, places man in an intolerable predicament, 
from which psychoanalysis purportedly rescues him but, 
in point of fact, only plunges him into the deeper. The 
time has come, if we are not to march straight to perdi- 
tion, to make an about-face and return to principles 
which a perilous and arrogant theology has led us to 
ignore and despise. 


Protestant Qiristianity: 

II. Challenge and Change* 

If, as the last section of the preceding chapter suggests, 
the Protestant Reformation was, in certain important 
respects, deviant and incomplete, there is urgent necessity 
for continued exploration, new insights, and social in- 
ventiveness. But in an area as intricate and vital as the 
one presently under consideration, ^'research" — in the 
conventional sense of that term — is not very meaningful. 
What is needed, instead, is broad trial and error, actual 
experience, or * 'action research'' as it is sometimes called. 
In the present chapter we review *' experiments'' of this 
type that are already under way and suggest certain other 
possibilities that deserve a hard try. 

Surely one of the main reasons why, as Pauck (Chapter 
11) says, the Reformation ''must go on" is the need to 
bring science and religion into a common, or at least 
cornpatible, universe of discourse. There is at present 
some lack of sanguinity on this score, borne of the 
consequences — already apparent to many — of our having 
tried to make religion mesh with the pseudoscience of 
Freudian psychoanalysis. We are now in process of get- 
ting a clearer vision of psychological and social realities; 
but Reformation theology has made its own distinctive 
contributions to present confusion and has an obligation 
to put its house in order, as well. To repeat a truism, a 
sound psychology and a sound theology will show con- 
gruence, not conflict, and should generate personal prac- 
tices and institutional forms decidedly superior to those 
we currently follow. 

In this lecture I shall make no systematic attempt to 
summarize the preceding one but will, instead, go directly 

* Delivered, in somewhat abbreviated form, at North Park 
College and Seminary on May 3 as Part II of the David Nyvall 
Lectures for 1960 and also presented, as a Geehns Lecture, at 
the Southern Baptist Theological Seminary. 


Protestantism: ii. Challenge and Change 177 

on with the main argument and analysis. However, I 
shall try to do this in such a way that those who may 
not have heard the first lecture will, by inference, quickly 
identify the assumptions on which we are operating and 
the objectives toward which we are aiming. 


In the first lecture I mentioned having attended, a 
few months ago, a very remarkable three-day conference. 
The group consisted of ten or twelve eminent seminary 
professors and parish ministers, with a sprinkling of 
psychologists and psychiatrists. And although I thought 
I knew something of the specialized, as well as common, 
language of the professions thus represented, by the end 
of the first day I was thoroughly mystified by what was 
being said and done, especially by the theologians. Ob- 
viously some new type of "group dynamics" was at work, 
which I did not at all understand — or, I confess, like. We 
had been called together (and were being paidl) to 
consider ways and means whereby the modern church 
can become more intelligent and effective in helping 
modern men and women live confidently, meaningfully, 
and creatively (in the best sense of that vastly over- 
worked term). But this group was obsessed by a cultus 
which was foreign to me personally and, as I perceived 
it, irrelevant and negative as far as the stated objectives 
of the meeting itself was concerned. 

By the end of the second day, with everyone picking 
at and on everyone else, as well as himself, and generat- 
ing an impenetrable intellectual and emotional fog, a 
little light began to dawn. Here, I surmised, were the 
Existentialism of Paul Tillich and the I-Thou philosophy 
of Martin Buber in action. My fellow conferees were, it 
seemed, trying to put into effect, in their personal and 
professional lives, what they understood these two specu- 
lative giants to be advocating. But then a chance remark 
provided a more specific cue; and when I returned home 
I hurried to consult a book which I had owned for some 
time but had not previously read: The Meaning of Per- 
sons by Paul Tournier (1957). At once it was clear that 
here was the manual which was inspiring and guiding the 
strange demonstration I had witnessed — a sort of Latter- 

178 The Crisis in Psychiatry and Religion 

Day Pentecost, but with the thunder and bolts of fire 
on a vastly reduced scale. The Fire, in fact, was mainly 
smoke and the thunder, just "noise." 

At this meeting a sort of pass-phrase which I heard 
repeatedly, in slightly varied versions, was: "But I want 
to get to know you, the real you." On the second page 
of his first chapter (which has as a title what Harvey 
Cox has recently characterized as "that hardly helpful 
question. Who Am I?"), Tournier says: 

Day after day men and women of all ages and conditions, 
the healthy as well as the sick, come to see me in order to 
learn to know themselves better. They tell me the story of 
their lives. They take great trouble to get the details abso- 
lutely right. They are seeking to know the person that they 
themselves really are. . . . 

What matters in this search for the person is not so much 
historical facts as the way in which we see and feel them. 
If our memories deceive us, the distortion that they have 
undergone is by no means accidental; it tells us as much 
about ourselves as do the facts themselves [italics added]. 

And a few pages later the author also says: 

The reader will see now why it is that this problem of the 
person has for twenty years been of such absorbing interest 
to me. It has a general significance which is of vital im- 
portance for all thought and all civilization: what is man? 
But it also has a particular significance, which is equally im- 
portant for my life: who am I, really, myself? 

It is a question which haunts each one of us, whether we 
are aware of it or not. It is there in every consultation I give. 
It is there for the man who comes to see me, and for me as 
well. This frank and living contact with people is the very 
substance of my professional life. It is for me, quite as much j 
as for the man who consults me, a means of discovering 
myself. I seek to attain it not only in my consulting-room,! 
but all the time, in every meeting with another person, in 
my own family, with my friends, in conferences, and on a 
holiday (p. 14). 

And my friends were doing it, too, at the conference 
— where, objectively, at least, they were supposed to be 
doing something else! But objectivity, we soon discover, 
is passe: 

When we evoke our memories, we can never be quite sur^ 
that we have banished all illusion from them, howevei 

Protestantism: ii. Challenge and Change 179 

sincere we are. What we call to mind is not the facts them- 
selves but their appearance, the way in which we saw and 
felt them. All that we have seen and felt — images and sensa- 
tions — remains more or less distorted in our memories (p. 

There was a tirrie when legend, poetry and music counted 
for more than science in the making of a cultivated man. 
, . . One of Pirandello's Six Characters in Search of an Au- 
thor declares that an imaginary being like Sancho Panza is 
more real than any real man. . . . Where then is the 
frontier between what I am and what I can become? (p. 13) . 

Even Sancho Panza is not identical for everybody; my idea 
of him is not the same as yours, or as that of Cervantes. 
. . . The same thing happens with all these people who 
come to see me, and take so much trouble over their efforts 
to describe themselves to me with strict accuracy (p. 14). 

Twenty years earlier, we discover, Buber in his booklet 
What Is Man? was making substantially the same point: 

When imagining and illusions are over, the possible and 
inevitable meeting of man with himself is able to take place 
only as the meeting of the individual with his fellow-man — 
and this is how it must take place. Only when the individual 
knows the other in all his otherness as himself, as man, and 
from there breaks through to the other, has he broken 
through his solitude in a strict and transforming meeting. 

It is obvious that such an event can only take place if the 
person is stirred up as a person (pp. 201-202). 

And precisely how is this to transpire? The answer: 

In real conversation, ... a real lesson . . . , a real em- 
brace and not one of mere habit, a real duel and not a mere 
game — in all these what is essential does not take place in 
each of the participants or in a neutral world which includes 
the two and all other things; but it takes place between them 
in the most precise sense, as it were in a dimension which is 
accessible only to them both. Something happens to me — 
that is a fact which can be exactly distributed between the 
world and the soul, between an "outer" event and an "inner" 
impression. But if I and another come up against one an- 
other, "happen" to one another, . . . the sum does not 
exactly divide, there is a remainder, somewhere, where the 
souls end and the world has not yet begun, and this re- 
mainder is what is essential. . . . 

On the far side of the subjective, on this side of the ob- 
jective, on the narrow ridge, where I and Thou meet, there 
. is the realm of "between" (p. 204). 

180 The Crisis in Psychiatry and Religion 

This reality provides the starting-point for the philosophical 
science of man; and from this point an advance may be 
made on the one hand to a transformed understanding of 
the person and on the other to a transformed understanding 
of community. The central subject of this science is neither 
the individual nor the collective but man with man (p. 205). 

What, then, can one say to all this? There is something 
undeniably appealing and wistful about it, but can it be 
put to work in the everyday world? In the same context 
from which the foregoing passages come, Buber refers to 
"something ontic," and there is now in Chicago and one 
or two other cities in this country an Onto-Analytic 
Society. And various forms of Existential Analysis have 
been practiced in Europe for some years. But is their 
record any better than that of psychoanalysis? In an 
oblique criticism of the latter, Buber writes: 

We have seen that an individualistic anthropolgy, an an- 
thropology which is substantially concerned only with the 
relation of the human person to himself, with the relation 
within this person between the spirit and its instincts, and 
so on, cannot lead to a knowledge of man's being (p. 199, 
italics added). 

The emphasis on the relation of man-to-man is, surely, 
an improvement upon Freudian doctrine; but is there not 
still a serious ambiguity here? The emphasis, as Tour- 
nier's phrasing especially suggests, is still upon one's 
coming to know himself. Don't we, in fact, know our- 
selves only too well and sicken of this knowledge, yet are 
loath to let others know, in the same sense, who we are? 
I do not mean "others" in the sense of a professional 
listener who is paid to keep our secrets, but in Sullivan's 
sense of the significant, ordinary others in our lives : rela- 
tives, friends, colleagues, neighbors. Here is where the 
real "break-through" to community and personal au- 
thenticity comes; and anything which falls short of this 
is, I submit, a pious hope. 


For the atmosphere created at the conference and the 
prevailing tone of the quotations from Tournier and 
Buber in the preceding section, there is surely only one 

Protestantism: n. Challenge and Change 181 

apt word: mystical. And since Orientals, rather than 
Westerners, have cultivated the occult so much longer, it 
is no accident that we should now be turning to them 
for real expertness in these matters. Zen Buddhism has 
already achieved at least a minor vogue in this country; 
and recently a full-page ad by Harper and Brothers in the 
Christian Century was headed: "Books on Eastern Reli- 
gions for Western Readers." A few weeks ago a former 
student, as a pleasant gesture, sent me a copy of The 
Wisdom of Laotse (Lin Yutang, 1948). Laotse was a 
Taoist, and Taoism is one of the direct and dominant 
tributaries of Zen. Open the Laotse book, almost at 
random, and here is the sort of thing one finds: 

Life arises from death, and vice versa. Possibility arises 
from impossibility, and vice versa. Affirmation is based upon 
denial, and vice versa. Which being the case, the true Sage 
rejects all distinctions and takes his refuge in Heaven (p. 49). 

And to this intellectual nihilism is added moral nega- 
tivism or at least neutrality. For example, we read: 

The man of character lives at home without exercising his 
mind and performs actions without worry. The notions of 
right and wrong and the praise and blame of others do not 
disturb him. When within the four seas all people can enjoy 
themselves, that is happiness for him; when all people are 
well provided, that is peace for him. Sorrowful in coun- 
tenance, he looks like a baby who has lost his mother; ap- 
pearing stupid, he goes about like one who has lost his way. 
He has plenty of money to spend, and does not know where 
it comes from. He drinks and eats just enough and does not 
know where the food comes from. This is the demeanor of 
the man of character (p. 129). 

Now it is a good thing, surely, to have international 
trade, both in the realm of material things and in ideas. 
But when we start importing and extensively appropriat- 
ing notions which by traditional Western standards are 
patent nonsense, we need to look well to our condition. 
If the line of thought we have pursued in the preceding 
lecture and thus far in this one is sound, the facts run 
something like this: The Calvinist doctrine of the guilt of 
man and the grace of God (or what Tillich has called 
the Protestant Principle) has been a heresy which has 
produced despair, anger, and madness. Freud, with a 

182 The Crisis in Psychiatry and Religion 

great flourish of scientific objectivity and logic, pretended 
to deliver us by going all the way and taking from us 
responsibility both for our sins and our salvation. The 
result: moral collapse and chaos! Now, feebly, in a sort 
of hebephrenic languor, we are toying with Asiatic abstrac- 
tions that make about as much sense as does modern ab- 
stractionist art. Is this the best we can do? Perhaps, 
but I believe there is an alternative way of approaching 
the problem which we should consider very seriously: 
namely, to assume that there are principles — universal, 
consistent, knowable principles — in the domain of hu- 
man personality and social process which transcend *'per- 
sons," and that we can know others and be ourselves, in 
the ultimate sense, only in terms of these principles. 

Today we are hearing a great deal, in some quarters, 
about God as person.^ But from the personal emphasis, 
we easily move to the subjective; and, as we have just 
seen, it is also but a short step from the subjective to 
mysticism and chaos. For myself — and here I think I 
speak for many others — what I want is a clearer knowledge 

^For example, Hordern (1955), in describing the theological 
position of William Temple, Archbishop of Canterbury, writes: 
■"The supreme revelation is given in the life and person of 
Jesus. The revelation is not his teaching or his acts but him- 
self. . . . Christianity is not a dedication to a system of rules 
or of thought, but a dedication to a person. This is unique 
among the religions of the world" (p. 190). This emphasis 
upon God-as-person is likely to strike the skeptic as a patent 
absurdity; and it is also, it seems, of doubtful practical assist- 
ance to the nominal believer when he is in emotional difficul- 
ties. One can rebuild his life, in a constructive and satisfying 
manner, along lines laid down by Christ's ethical teachings; but 
the notion of the "mystical" union with Christ has, I submit, 
little value save as a topic for endless theological disquisition. I 
once took a young Polish psychologist (who was, I presume, 
also something of a Communist) to the first Christian church 
service he had ever attended; and afterwards, he was quiet for 
a few minutes and then thoughtfully asked, "And what are 
all those people going to do now?" What could I say? The 
truth is there isn't much that a person can do about much 
Protestant preaching, except to go back next week and hear 
more of it. The de-emphasis on preaching and stress upon 
action, deeds, works in the Catholic Church surely has some- 
thing to recommend it. (Cf. a similar emphasis in the Mormon 
and Moslem religions.) ^ 


Protestantism: ii. Challenge and Change 183 

of principles, which we can learn to obey and thereby 
live abundantly or, if we choose, disobey and suffer the 
consequences. A friend who is a state mental hospital 
chaplain tells me that a point which he often makes with 
patients is this: "We don't break God's laws. They 
break us, if we disregard or defy them." Isn't this 
what we need to know, more about how the Universe is 
constructed and operated, in the psychological and moral 
realm, so that we can conduct our lives more intelligently 
and more meaningfully? If, in the physical realm, we 
observe the Laws of Gravity, we get along nicely; if, on 
the other hand, we disregard them, we may have a 
broken neck to show for it. But do we "break" the prin- 
ciples of gravity? Not in the least, they break us. 

There is thus, as I see it, no place for Calvinistic logic 
in the modern world: we have, it seems, a completely 
symmetrical choice between observing natural principles 
and prospering, on the one hand, and disregarding them 
and getting into trouble, on the other. And we have 
just as much responsibility — and deserve just as much 
"credit," positive or negative — in the one case as in the 
other. If we are to end the wasteful and undignified 
conflict between scientific and religious world views, it 
must surely be along these lines; and it is, I submit, 
along the very same lines that the ecumenical movement 
within religion itself also has the best prospects of suc- 
cess. As long as different religious groups focus upon 
personages, which are of necessity unique, they will 
remain apart; but when they begin to look at the prin- 
ciples which they have in common, reconciliation and 
union are by no means improbable. 

Especially interesting in this connection is another 
passage from the article by Richard Niebuhr which I 
have already [Chapter 11] cited. It reads as follows: 

Experience and study [over the past 25 years] both have 
led to some changes in the theological formulation of [my] 
convictions. The complex, dynamic, interhuman as well as 
the human-divine interaction of trust and loyalty has excited 
my wonder and challenged my efforts to understand faith 
more than ever. Perhaps it is this concentration on faith 
as trust and loyalty which had led me farther away from the 
road that many other postliberals — particularly Karl Barth — 
have taken. So many of them seem to me to have gone back 

184 The Crisis in Psychiatry and Religion 

to orthodoxy as right teaching, right doctrine, and to faith 
as fides, as assent; they tend, it seems to me, toward the 
definition of Christian hfe in terms of right beheving, of 
Christianity as the true rehgion, and otherwise toward the 
assertion of the primacy of ideas over personal relations. 
When I think about this I have to say to myself that impor- 
tant as theological formulations are for me they are not the 
primary one. I discover further a greater kinship with all 
theologians of Christian experience than with the theolo- 
gians of Christian doctrine. So I find myself, though with 
many hesitations, closer to Edwards and Schleiermacher, to 
Coleridge, Bushnell and Maurice than to Barth and the 
dogmatic biblical theology current today in wide circles. To 
state my understanding of our theological situation briefly: I 
believe that the Barthian correction of the line of march 
begun in Schleiermacher's day was absolutely essential, but 
that it has become an over-correction and that Protestant 
theology can minister to the church's life more effectively if 
it resumes the general line of march represented by the evan- 
gelical, empirical and critical movement. Some new studies 
in modern theology have convinced me that the movement 
from Schleiermacher to Troeltsch was by no means so hu- 
manistic as its critics have asserted. Existentialism also has 
served to reinforce my concern for the personal, for the reli- 
giously experienced, for I-Thou relations between God and 
man and between men. Among contemporary theologians it 
is Bultmann who above all seems to me to represent this em- 
pirical and ethical strain in theology (pp. 249-250, italics 


Here, as I see it, is an attempt to dissociate religio 
from theological arrogance and abstraction and to relate 
it to on-going human and social experience and need, 
in a way which is immediately attractive to the person 
with naturalistic, scientific, and humanistic predilections. 
Here there is hope of finding principles of living on 
which parish ministers and social scientists can deeply 
agree. Here is an attempt, as Niebuhr explicitly states, to 
make religion empirical, to validate it by its accomplish- 
ments, instead of reducing it to a set of dogmatic as- 
severations which are to be taken purely on faith, without 
any reference to the consequences which flow from them 
in the real world. 

Niebuhr's emphasis upon the personal and interper- 
sonal is, therefore, a very welcome one — and sound, pro- 
vided it is interpreted and implemented in terms of 

Protestantism: ii. Challenge and Change 185 

definite principles, rather than as a "Cloud of Unknow- 
ing" (to borrow the title of the anonymous book on 
medieval Christian mysticism which Progoff, 1957, has 
rendered into modern English ) . The need for a synthesis 
of science and religion in the psychological and social 
area is today very great, and here, in the realm of the 
personal and the interpersonal, is manifestly the place to 
begin. But this enterprise will not prosper if we rest con- 
tent with the amorphous utterances of Buber, Tournier, 
and other Existentialists or if we drift off into the frank 
anti-intellectualism and ethical nihilism of certain Asiatic 
philosophies. This is a capital challenge to both con- 
temporary social scientists (see Mowrer, 1961) and to 
clear-minded and courageous religious leaders, such as 


It is, of course, painfully clear that the obstacles to a 
return to principle in the moral and spiritual realm are 
formidable. From Luther down to this very day, there is 
a subtle but powerful Protestant doctrine which is the 
very antithesis of consistent, objective principle in this 
area. Recently I heard a bright well-educated young 
minister preach a sermon from which I wish to quote at 
some length: 

In the first place, we need to understand what it means to 
say that we are sinners. Usually we mean by "sinner" some- 
body who has broken a rule or violated a law, someone who 
doesn't conform to accepted moral and social standards. . . . 

But that isn't what sin means in the Bible! Sin is not the 
accidental breaking of a rule, but the willful violation of a 
personal relationship. We don't sin against rules, we sin 
against persons. The Biblical God relates to his people not 
primarily as a Judge to an offender, but as a Father to a son 
who has rejected his love and wandered away into a far 
country. Sin is what we were talking about last week. It is 
the condition into which men meet each other from behind 
masks, afraid to be known for what they are. Sin is when we 
build walls of isolation and security to avoid the demand of 
men to be loved as ourselves. Sin is the "thingification" of 
persons — the using of human beings for what good they can 
do us, rather than the seeking of genuine human community. 
Sin is the ritual that allows us to glad-hand and smile and 

186 The Crisis in Psychiatry and Religion 

date without ever knowing the person we so casually "con- 
tact." Have you ever been talking with someone and then 
realized that you hadn't really heard a word he or she was 
saying? Have you perhaps lived with a person and gone 
through the motions of friendship or marriage and suddenly 
realized you didn't really know him? 

And now it isn't so easy to slough off our responsibility, 
is it? We may never violate the commandments, but we 
may know very well what it means to treat persons as things. 
Listen to our poets, our dramatists, our sociologists, our 
philosophers, our beatniks. They all speak with one voice, 
and ask: ''How can we stop brushing by each other the way 
we brush by a blackboard or a bush? How can we start 
being human to each other?" That question shows that, by 
whatever name it is called, sin is a reality to modern man. 

Here we have it! Sin is not the grubby, mean, vicious, 
duplicitous, self-defeating and socially destructive things 
we do. It can't be that simple — otherwise, we would not 
perhaps need so much preaching, so much explaining to 
understand it. No, it is something much more compli- 
cated, which only the professional theologian can fully 
fathom. And this is what he preaches and teaches to the 
laity, despite the fact that, as we have seen, when he 
personally gets into emotional hot water, he finds it 
precious little help, judging by the alactrity with which 
he is likely to resort to a secular therapist of some sort 
[see Chapter 11]. 

This distinction between sins and Sin was, of course, 
stressed by Luther, during the Reformation, in his attack 
upon the opposite emphasis of the Catholic Church. 
But it has extensive roots back in the New Testament 
itself in the writings of the Apostle Paul; and it is no ac- 
cident that the sermon from which the foregoing quota- 
tion is taken was buttressed by texts from the Letter to 
the Ephesians, wherein the familiar Pauline doctrine of 
justification by faith is expounded as follows: 

But God, who is rich in mercy, out of the great love with 
which he loved us, even when we were dead through our 
trespasses, made us alive together with Christ (by grace you 
have been saved), and raised us up with him, and made us 
sit with him in the heavenly places in Christ Jesus, that in 
the coming ages he might show the immeasurable riches of 
his grace in kindness toward us in Christ Jesus. For by grace 
you have been saved through faith, it is the gift of God — not 

Protestantism: ii. Challenge and Change 187 

because of works, lest any man should boast. For we are his 
workmanship, created in Christ Jesus for good works, which 
God prepared beforehand, that we should walk in them 

But now in Christ Jesus you who once were far off have 
been brought near in the blood of Christ. For he is our 
peace, who has made us both one, and has broken down 
the dividing wall of hostility, by abolishing in his flesh the 
law of commandments and ordinances, that he might create 
in himself one new man in place of the two, so making 
peace, and might reconcile us both to God in one body 
through the cross, thereby bringing the hostility to an end 

Here, clearly, is Biblical authority for Luther's enig- 
matic injunction to "Love God and sin boldly" (since 
our sins are already forgiven before we commit them) 
and, equally, for Calvin's doctrine of predestination 
("which God prepared beforehand"). Paul (Ephesians 
3:4) concedes that all this is "the mystery of Christ" 
but claims he has "insight" into it. Can it be that the 
mystery is largely of his own making and that although 
he perhaps understood it, few have since been similarly 

It is not surprising, perhaps, that Lloyd C. Douglas, 
while he was still a Congregationist minister, and before 
he became a great novelist, often referred to Paul as 
"that noisy troubadour from Tarsus!" Even though his 
mellifluous phrases have rumbled on down through the 
centuries, it is still not certain whether they make any 
real sense. In Paul's own time, he had a trenchant critic 
in the writer of the Epistle of James, who needs only 
three and a half pages to refute the essence of what 
Paul takes 88 pages, or nearly a third of the New Testa- 
ment (RSV), to say. 

What does it profit, my brethren, if a man says he has 
faith but has not works? Can faith save him? If a brother or 
sister is ill clad and in lack of daily food, and one of you say 
to them, "Go in peace, be warm," what does it profit? So 
faith by itself, if it has no works, is dead (2:14-17). 

Show me your faith apart from your works, and I by my 
works will show you my faith (2:18). 

You see that a man is justified by works and not by faith 
alone. And in the same way was not also Rahab the harlot 
justified by works when she received the messengers and sent 

188 The Crisis in Psychiatry and Religion 

them out another way? For as the body apart from the 
spirit is dead, so faith apart from works is dead (2:24-26). 

Fundamentalists, literalists, and revelationists some- 
times make a great point of the internal consistency of 
the Bible. One need not be a Biblical expert to know 
that James was in direct and emphatic disagreement with 
Paul. And K. W. Lowther Clark, in his authorative Con- 
cise Bible Commentary, adds: "The impulse [which 
prompted the Epistle of James] was supplied by the 
desire to recall Christians to reality in religion; [the 
author] had seen the unfortunate impression made on 
some minds by reports of St. Paul's teaching and wished 
to counteract if (p. 915, italics added ).2 

^ Since the above was written I have received a letter from 
a clergyman of Calvinist persuasion which reads in part as 
follows: "Ever since your opening address [see Chapter 8], I 
have also wondered about something else which maybe you 
could answer for me. If I remember correctly, it was your 
belief that many times we make forgiveness too easy. Man has 
worked his way into sin; he must somehow be given the op- 
portunity to work his way out. Your reference to the old- 
fashioned mourners' bench especially intrigued me. Could it be, 
however, that this is due to the fact that we have separated the 
doctrine of the substitutionary atonement from the offer of 
forgiveness? I mean that if we preached, what I believe to be 
the teaching of the Bible, that Christ was bearing the wrath of 
God against sin, that he was being punished for my sin, that 
we would not think of it as cheap and easy? I can never atone 
for my sin, but Christ has done that for me. He has paid the 
price. He bore the punishment due me; and my union with 
him through faith means that my sins have been punished and 
I can now have a clear, clean conscience." Here is an epitome 
of the Great Idea which Reformation theologians spread 
abroad in the world! If one is pleased with the present status 
and prospects of Protestantism, after four hundred years, one 
should by all means persevere in this ambiguous and bloody 
doctrine. But for a growing minority (or is it now, in fact, 
majority?), it just won't do. The discrepancy between the be- 
liefs professed by many modern ministers from their pulpits 
and their personal practices when in emotional difficulties has 
been commented on in some detail in the first lecture of this 
series. And a little later in the present discussion, we shall 
allude, at least sketchily, to the much over-worked concept of 
forgiveness. However, no attempt is made here [or elsewhere in 
this volume] to deal in any systematic way with the whole 

Protestantism: ii. Challenge and Change 189 

Although the CathoHc Church has made a mystery 
and a muddle of many things, in this issue between 
Paul and James it has been clear-headed — and thoroughly 
Jamesian. It has stressed the importance of good works 
(as a means of correcting sins, without much reference 
to Sin)y with implicit recognition of a "balance sheet" on 
which our sins and virtues add algebraically. As Tillich 
(1959) observes in the sermon previously cited: 

Our moral balance sheet is not so bad as it would be with- 
out these acts! And did you ever see a preacher of what is 
called the "total depravity" of man who did not show in his 
own behavior a reliance on a positive moral balance sheet? 
(p. 17). 

But the emphasis in the writings of Paul, and in Prot- 
estant theology generally, has been on a very different 
note, namely, that in the Substitutionary Atonement 
(Christ's crucifixion), Cod wiped the ''balance sheet" 
clean for all time and for all men, provided only that 
they say, "I believe. . . ." In "accepting Christ as our 
personal redeemer," sin is supposedly banished in our 
lives and we are, from this point on, "saved." This is 
what Deitrich Bonhoeffer, in his book The Cost of 
Discipleship, dubs the doctrine of cheap grace, a doctrine 
which has been a disgrace and a scandal to Christendom. 
It is a doctrine which holds the deep natural wisdom of 
the Judeo-Christian ethic in contempt — and prevents us 
from coming to grips effectively with the most profound 
personal problem of our time, mental illness. 


The crux of our present predicament, then, is that 
Protestantism has embraced a theology which put the 

notion of sacrifice, as a therapeutic force. Although Christ un- 
doubtedly made a great personal sacrifice (of allowing himself 
to be crucified for his conviction, rather than quietly slipping 
off into the desert, as he easily could have), I believe a wholly 
unjustified cult has grown up around this act which completely 
distorts the historical facts and blinds our present-day percep- 
tion in some vitally important areas. However, this topic is so 
complex, and vital, that I am reserving it for special treatment 
in a lecture to be given shortly at the Allan Memorial Institute 
of Psychiatry, at McGill University, in Montreal. It will be 
published separately, at a later date. 

190 The Crisis in Psychiatry and Religion 

problem of personal guilt beyond the scope of religion 
and thus fostered the development of secular psycho- 
therapy in general and Freudian psychoanalysis in partic- 
ular. But analytic treatment and theory, far from lessen- 
ing our woes, have exacerbated them; and we are today 
looking to religion, once again, with renewed hope and 
urgency. We have tried to believe that personality dis- 
order is basically an illness — mental illness; but we are 
now increasingly persuaded that the problem is funda- 
mentally moral, that the guilt which is so obviously 
central in psychopathology is real rather than false, and 
that only a moral attack upon this problem can be suc- 
cessful. We had hoped that an easy solution might be 
found for personal evil; and we have tried both the doc- 
trine of ''cheap grace" (in religion) and the strategy of 
denying the reality of sin and guilt altogether (in psy- 
choanalysis), but neither has worked. And so today 
there is a growing readiness to accept the verdict that 
''therapy," or "salvation," is possible only at great cost: 
the cost of self-revelation, deep contrition, and a radi- 
cally changed way of life. 

The injunction to engage in auricular confession is 
still to be found in the Protestant Episcopal Book of 
Common Prayer; and a similar admonition is also present 
in most forms of Lutheranism. However, the actual prac- 
tice of confession has largely fallen into disuse in these 
denominations; and among more radically Protestant 
groups, confession has long been regarded as papish and 
hence to be shunned like the plague. In the pastoral 
counseling movement, there has, of course, been a sort of 
half-hearted, disguised return of confession. But this 
movement has been so dominated by ideas and tech- 
niques which have been appropriated from secular forms 
of psychotherapy that the results have been quite am- 
biguous. Protestant churches must, I believe, rethink and 
revitalize their efforts in this direction. 

Luther, we should recall, was not protesting against the 
institution of confession as such, but against its abuse. 
Over the years, however, the assumption seems to have 
developed that the only way to prevent this abuse is to 
eliminate the institution itself. This is like arguing that 
because surgery, in incompetent or unscrupulous hands, 
can be misused, it should be eliminated altogether. Mani- 

Protestantism: ii. Challenge and Change 191 

festly some means must be found whereby ordinary 
mortals can work through the problem of personal guilt 
n a way which is more effective than anything which is 
it present generally available. And the indications are 
:hat confession, in a moral and religious context, is the 
ogical starting point. In his book. Life Together, Deitrich 
Bonhoeffer devotes the last chapter to the topic of "Con- 
iession and Communion." Here he says: 

"Confess your faults one to another" (Jas. 5:16). He who 
is alone with his sin is utterly alone. It may be that Chris- 
tians, notwithstanding corporate worship, common prayer^ 
and all their fellowship in service, may still be left to their 
loneliness. The final break-through to fellowship does not 
occur, because, though they have fellowship with one an- 
other as believers and as devout people, they do not have fel- 
lowship as the undevout, as sinners. The pious fellowship 
permits no one to be a sinner. So everybody must conceal his 
sin from himself and from the fellowship. We dare not be 
sinners. Many Christians are unthinkably horrified when a 
real sinner is suddenly discovered among the righteous. So we 
remain alone with our sin, living in lies and hypocrisy. The 
fact is that we are sinners! (p. 110). 

In confession the break-through to community takes place. 
Sin demands to have a man by himself. It withdraws him 
from the community. The more isolated a person is, the 
more destructive will be the power of sin over him, and the 
more deeply he becomes involved in it, the more disastrous is 
his isolation. Sin wants to remain unknown. It shuns the 
light. In the darkness of the unexpressed it poisons the 
whole being of a person. This can happen even in the midst 
of a pious community. In confession the light of the Gospel 
breaks into the darkness and seclusion of the heart. The sin 
. must be brought into the light. The unexpressed must be 
openly spoken and acknowledged. All that is secret and 
hidden is made manifest. It is a hard struggle until the sin 
is openly admitted. But God breaks gates of brass and bars 
of iron (Ps. 107:16) (p. 112). 

In his book The Riddle of Roman Catholicism, Jaro- 
;lov Pelikan writes: 

Through the administration of these three steps — contri- 
tion, confession, and satisfaction — the church has a splendid 
opportunity to apply the healing power of the gospel to the 
concrete needs of the penitent. In the hands of a conscien- 
tious pastor, the sacrament of penance makes divine grace 

192 The Crisis in Psychiatry and Religion 

meaningful without minimizing the individual's responsibil- 
ity for his sin. It is, at its best, a truly evangelical means for 
"the cure of souls," one whose benefits Protestantism has 
discarded too easily, and one for which a friendly chat with 
the minister is not a satisfactory substitute. Psychologically, 
too, private confession is sound, enabling a person to "come 
clean" about his feelings and to know that he has forgive- 
ness from God in spite of anything he may have done. The 
therapeutic value of this is difficult to overestimate (pp. 

And Meehl et at (1958), in their book What, Then, 
Is Man?y take a similar position. They say: 

One of the facets of confession which is often viewed 
superficially in pastoral practice, or even ignored, is the de- 
tailed or specific confession of actual sins. Many of the 
Lutheran clergy do not minister to the needs of their parish- 
ioners adequately because they are content when their peo- 
ple participate in general confessions instead of insisting 
upon the health-giving function of specific confessions, as 
the Lutheran Catechism and standard works in Lutheran 
pastoral theology recommend. The result has been that the 
act of confession has become secularized. Educated people 
especially seem more often to feel that their needs are better 
met by psychoanalysis than the Word of God. Our pastors 
ought to re-examine both the healing power of the Gospel 
and the apparent self-sufficiency of their parishioners. 

If the non-Christian psychotherapeutic effort has become 
vastly greater in our society and has obtained enormous recog- 
nition among our own people, it is in part the consequence 
of superficial pastoral care. Though it must not become ex- 
aggerated, so that it confers upon the pastor the role of 
grand inquisitor, there is nonetheless such a thing as peniten- 
tial discipline to which all Christians ought regularly to sub* 
mit. Self-knowledge really exists only to the extent that one 
does, or is able to, communicate it in speech to another 
person. The psychotherapeutic value of making specific, or 
even detailed, confessions is therefore very great (pp. 68-69). 

As it happens the three writers just cited are all Lu- 
therans. But men in other Protestant denominations have 
made similar statements, some of them very much earlier 
than the ones we have just reviewed. For example, Hol- 
man (1943), in a review of H. E. Fosdick's book. On 
Being a Real Person, wrote: 


Away back in 1927 Dr. Fosdick, then pastor of the Park 
Avenue Baptist Church, New York City, gave an address 
before the Greater New York Federation of Churches which 
immediately brought expressions of angry resentment or warm 
approval from Protestant ministers in all parts of the country. 
Said Dr. Fosdick: 

"We modern Protestants fail in some things. Our . 
Roman Catholic brethren in keeping the confessional 
have pretty nearly wiped us off the stage in one feature 
of human service. . . . 

*Tor six years I have conducted — Baptist though I am 
— what I call a confessional. ... I have an office 
where people who know they are spiritually sick and 
mentally disturbed can come with their problems. Why 
shouldn't I minister to them? Never again will I be 
without such a place where people can meet me alone. 
Week after week I meet nearly as many people as a 
priest. They are mentally unbalanced — sick souls who 
need ministration" (p. 214). 

What, then, has thus far been the fruit of this grow- 
[g awareness of the need for a return to confession in 
le Protestant churches? Fosdick's early interests were, as 
e know [Chapter 6], very largely absorbed and diverted 
f the pastoral counseling movement, which has been 
3minated by ideas taken from Freudian psychoanalysis 
id the counseling methods of Carl Rogers. This move- 
lent leaves much to be desired; and it is not without 
gnificance that there is a new concern, on the part of 
ich men as Bonhoeffer, Pelikan, and Meehl, with the 
lerapeutic and redemptive potentialities of confession. 
t the same time, however, there are some deep-seated 
id at least partially justified reservations. We have con- 
antly before us the fact that confession has long been, 
id is still, practiced in the Catholic Church, with results 
hich are not entirely reassuring. In later sections we 
lall go into this problem in more detail; but here the 
)llowing considerations are in order. 

Whenever confession as a means of personal redemp- 
on and change is under discussion, the question is sure 
) be asked, and not unreasonably: Do Catholics enjoy 
ly better mental health than do members of other reli- 
ions or, for that matter, nonreligious persons? Mental 
ospital statistics are likely to be quite ambiguous on this 

194 The Crisis in Psychiatry and RELIGIO^ 

score. The religion of an entering patient, if any, wil 
ordinarily be recorded without much reference tc 
whether the individual has recently been religiously active 
or inactive, thus obscuring the effects of the conscientiou: 
observance, or disregard, of the tenets of his faith. Bui 
there are independent indications — such as lower suicide 
rates, lower divorce rates, and greater resistance to **battl( 
fatigue" — that Catholics do have some advantage in thi: 
connection. However, the difference is not dramatic.' 
Catholics, laymen and members of the monastic anc 
priestly orders alike, suffer from personality disturbance 
both mild and severe, thus indicating that confessior 
either does not have the redemptive and therapeutic 
powers sometimes attributed to it or that — and here i: 
the point of special interest — there are serious weaknesse 
in the way confession is practiced by Catholics. I wish t( 
discuss these weaknesses in the following order. 

1. Catholic confession is often little more than at 
empty, perfunctory formality. I have a friend who, whei 
the occasion offers, makes a practice of sitting in Catholi( 
Churches throughout the country and noting the tim< 
which penitents spend in the confessional booth. Oi 
the average it turns out to be about 60 seconds. And \ 
Catholic chaplain in a V. A. hospital recently volunteere( 
the information that the confessions he hears from tb 
patients who are entrusted to his care usually run from 4( 
seconds to three minutes. Unless extensively supple, 
mented by interviews outside the confessional, this typ. 
of procedure can hardly be adequate to the needs of evei 
ordinary persons, to say nothing of those who are in peij 
sonality crisis. \ 

Priests vary enormously in the extent to which they arj 
interested in the confessional. Many are frank to say thaj 
they get through with this duty just as speedily as pos] 
sible, in order to have more time for other concerns. Oi 
the other hand, there are priests who give major attentioi 
to this aspect of their work and who become widel; 
known and sought after as confessors. These are th 
men who are likely to become known as "spiritual direc 
tors." But there is apparently no great pressure upoi 

® There is, moreover, some indication that in Catholi 
countries the incidence of suicide is not accurately reported 
because of the great opprobrium associated with this act. 

iotestantism: ii. Challenge and Change 195 

iests to emphasize the confessional, except in its sacra- 
ental aspects; and there is also, it seems, no scarcity of 
ithoHc laymen who are as willing to handle their confes- 
ms every bit as routinely as are many priests. 

2. The penance assigned is often not psychologically 
equate. Although I have not yet located documentary 
oof for it, Catholic priests tell me that there was a 
ne in the history of the Church when penances were 
iich more severe than they are today and were more 
arly designed to ''fit the crime." Now penance often 
v^olves nothing more than saying some extra prayers and 
rhaps burning a few candles. We know, of course, that 
dividual human beings, when overwhelmed by remorse 
d guilty fear, are inclined to be quite hard on them- 
ives; and it is not surprising, therefore, that the pen- 
ces assigned by the Church often leave the sinner in 
Jtate of unassuaged personal guilt and anguish. 

3. Confession is not an adequate deterrent. This criti- 
;m is most often heard from non-Catholics, but Catho- 
s themselves are not unaware of it as a problem. For 
ample, a young priest once told me the following story, 

one that circulates in Catholic circles. A peasant went 
the village priest and said, ''Father, I have sinned." 
f'es, my son," came the reply, "what is your sin?" 
i'ather," said the peasant, "last night I stole a bale of 
:aw. No, make that two bales, I want to get another 
le tonight!" 

Those who have been caught in a disgraceful deed or 
10, from bad conscience, have had to make a painful 
nfession thereof know that having one's failures and 
ortcomings become known by significant others is, in 
ct, an extremely powerful corrective of behavior. But 
e fact that confession is not expected to go beyond 
e priest and commonly involves a mere token penance 
n hardly fail to limit its effectiveness both as a means 
assuaging guilt and of deterring action when inner con- 
3ls are weak. 

4. Absolution and forgiveness are questionable proce- 
ires. Protestant churches do not, of course, lay claim to 
ipostolic succession" in the power to forgive sins; but 
ey do preach a doctrine of divine forgiveness and ab- 
lution of sorts. Let us examine this concept in a strictly 
iman, interpersonal light. A few months ago, partly as 

196 The Crisis in Psychiatry and Religioi 

an inadvertence and partly out of slight exasperation, i 
made a very unfortunate remark to a woman of my ao 
quaintance. I immediately realized that she was emba! 
rassed, and I was deeply remorseful. But I didn't attempi 
any sort of apology, and she never said anything in th 
way of "forgiveness." Nevertheless, after this incideni! 
she was even more kindly and respectful in her behavici 
with me than she had been before. I knew, therefon: 
that she was not going to indulge in the luxury of beinl 
resentful toward me or of rebuking me. She, manifestly! 
had "forgiven" me in the sense of rising above the incj 
dent herself; but this made my guilt and remorse eve! 
greater, not less. I 

This incident set me thinking about the logic and ps;| 
chology of forgiveness in general. How can another, eitht 
in a religious or purely personal setting, forgive us? ThI 
misdeed, the sin is ours; and who would presume, an' 
whom would we ask, to remove this responsibility? If wj 
have erred, do we not wish to make restitution, insteai 
of being "excused"? Forgiveness in the usual sense of th; 
term is, I feel, an act of great condescension and not i\ 
all likely to restore either our self-respect or peace (I 

Therefore, in keeping with a greater emphasis on per 
ance and meaningful restitution, I would like to see Pro; 
estant churches, as they reconsider the institution of cor 
fession, stress restitution and reform, not forgiveness. I 
our consciences have enough rectitude to bother us whe 
we act badly, I believe they will also approve and suppo 
us when we have done the best we can to correct oi 

Extensive documentation of the psychological inad* 
quacy of religious confession and assurance of forgivene 
as commonly practiced is not readily available. But Meel 
et ah, in the volume already cited, related the followin 

A young woman confessed that she had broken the Se^ 
enth Commandment [Lutheran numbering; eighth in th 
Reformed system] by pilfering ribbons and socks from 

*In discussing this matter with a colleague recently, I wa 
much interested in his opinion that forgiveness is "a profomr 
irrelevancy in human affairs." 


dime store. She was obviously contrite about the transgres- 
sion, and the pastor assured her of God's understanding and 
gracious forgiveness. In a few weeks she was back in the study 
to confess that she had stolen again, this time a few cents 
from her mother's purse. Again absolution was pronounced. 
When, not too many days after this, the girl again came in 
tears, the pastor began looking more deeply. Professional help 
was called in to assist the girl. Serious deficiences in her 
home life were uncovered. It became apparent that she had 
unexpressed misgivings about whether God had actually for- 
given her after her previous confessions. While she had re- 
pented of the sin that she knew, she recognized her inability 
to straighten herself out; this feeling created internal doubts 
about her confession. As these feelings were brought out and 
she began to understand them, the urge to steal waned — 
and the absolution was accepted and believed (p. 284). 

Here we see, first of all, the inadequacy of the simple 
ormula of confession and assurance of divine forgive- 
less.^ The unfortunate behavior continued, so 'Trofes- 
ional help was called in to assist the girl." What more 
eloquent testimony could one ask of the loss of authority 
md confidence on the part of the clergy than the tend- 
;ncy to regard secular healers as the "professionals" in 
his area? If, as we now increasingly suspect, moral issues 
ire nuclear to every neurosis, isn't it remarkable that the 
:lergy no longer regards itself as first in competence here? 
n the particular instance cited, therapy along the familiar 
ines of insight and understanding was ostensibly suc- 
cessful. But, in the large, we know the picture is not a 
jood one, that secular therapy predicated on the common 
issumptions about repression, mistreatment, and the like 
iocs not have a reassuring record; and this is why there 
s a growing feeling that we should re-examine, revive, 
fnd revise the institution of confession so as to make it 
psychologically and ethically more meaningful and ade- 
|uate. This, it seems, is a challenge that is pertinent not 
)nly to the Protestant denominations but to Catholicism 
[IS well.^ 

^See also Weatherhead (1957), especially Chapter 7, on 
'The Difficulty of Feeling Forgiven." 

"A recent newspaper report indicates that the Catholic 
phurch has under consideration a proposal to increase the 
everity of penances, to accord with earlier — ^and probably 
oundei — ^practice. 

198 The Crisis in Psychiatry and Religion 


In the discussion period following another lecture, I 
received this written question and comment: 

How would you interpret Jesus' reference to the pharisees 
as whited sepulchres — outwardly made beautiful and inside, 
old bones and dead men's bodies? The outward beauty ob- 
viously refers to the pharisees' assumed goodness and the 
old bones and dead men's bodies must refer to repression 
and undeveloped life. 

The reference is here, of course, to Matthew 23:27; 
and on many other occasions Christ rebuked the Pharisees 
for their tendency to pray and give alms in public and 
otherwise exhibit their piety. 'They have their reward," 
was his summary evaluation. 

Those who are looking for it can, of course, easily find 
here an apparent repudiation of the doctrine of good 
works. But how, then, are we to interpret the story of the 
Good Samaritan and dozens of other similar incidents 
reported in the New Testament? No, clearly the objec- 
tion is not to good deeds as such — far from it!, but to 
boasting and exhibitionism with respect to the virtue or 
credit thus achieved. But to this aspect of the problem 
Christ, himself gave the solution: when you perform 
charity, do it, as often as possible, in secret: "Let not 
your left hand know what the right hand doeth." Is this 
so hard to understand and practice? 

As if the Bible itself were not sufficiently explicit on 
this score, Lloyd Douglas, in both Magnificent Obsession 
and Doctor Hudson's Secret Journal, elaborates and 
dramatizes this point for us around the idea that reaL 
''power," as he calls it, comes only when we do good: 
by stealth. Dr. Hudson (the central character in both| 
these books) holds that most of us live lives which are! 
blighted by chronic insecurity, doubt, and despair because \ 
we characteristically display our virtues, and good deeds, j 
and hide our sins and shortcomings. We are, so to say,^ 
chronically in debt and in danger. How, then, can we 
resolve the situation? It is obvious, says Dr. Hudson:, 

'kotestantism: ii. Challenge and Change 199 

)isplay, admit, confess our sins and hide our good works, 
uch a strategy, he argues, helps us, slowly but surely, to 
love from anxiety, depression, and indecision to con- 
dence, inner strength, and joy — or, as he calls it, 

Another argument which we often hear in this connec- 
ion is this: "But many of our sins are of such a nature 
iat we carCt atone for them." This, in the literal sense, 
;, to be sure, often true. But we can try — and if we 
ersevere long enough, knock hard enough, the door 
ventually opens. The atonement or restitution doesn't, 
f course, have to be "in kind," i.e., made precisely to the 
erson who has been wronged or hurt, or be precisely on 
le point of the original misdeed. There is always need 
3r service of other kinds in the world; and who is to 
ly that sacrifice for a good cause is less worthy as "justifi- 
ation" than is a specific reparation? 

Sometimes psychologists and psychiatrists who do per- 
3nnel assessment work for seminaries and mission boards 
'ill damn a candidate on the grounds that he is "moti- 
ated by personal guilt." Is this necessarily bad? How 
lany men and women, one wonders, have saved them- 
dves from mental illness or worse by this very device? 
'he important thing, I suspect, is that the individual be 
lear-headed about what he is doing and why he is doing 
:. If these conditions are met, I should be inclined to 
xpect such a motivation to augur for success rather than 
le reverse. What other type of motivation would we re- 
ard as sounder? Or what better means of dealing with 
ersonal guilt would we suggest? 

Of course, the whole idea of atonement is foreign to 
ur modern way of thinking about personality disturb- 
nces. Such disturbances, we have been told and told 
gain, come from false guilt, from lack of insight, from 
ver-conscientiousness; so what is there to confess, much 
jss realistically atone for? The "need for punishment" 
1 neurotic individuals has, of course, long been recog- 
ized; but it has been largely dismissed as the "masochis- 
ic" aspect of neurosis itself. In other words, it too was 
2en as irrational, a form of sickness rather than a sensible 
nd healthy striving toward wholeness. 

But the times are changing. Recently The Psychiatric 
'bulletin of the University of Texas carried a feature 

200 The Crisis in Psychiatry and Religion 

article entitled "Retribution and Neurosis," the introduc- 
tory paragraph of which reads as follows: 

In many kinds of emotional illness or maladjustment, guilt, 
whether conscious or unrecognized, coexists with an assump 
tion of punishment. Sometimes any disorder or event is inter 
preted as such. Patients may feel doomed or fated to undergo 
some tragedy or committed to a course of action that wil 
culminate in disaster. Others may explain a chronic illnes! 
or develop a functional one as a retributive measure. Twc 
related versions of this manifestation are described as the 
talion principle and the nemesis concept (p. 16). 

There then follows a discussion of the talion anc 
nemesis principles, which I assume are well known. Bui 
in a section entitled "Treatment," a new note is struck 
Here there is no reference to the classical Freudian doc 
trine of false guilt as basic to neurotic difficulties. In 
stead we read: 

Patients may be anxious, phobic, or obsessive, for example 
but their basic fear is also their method of coping with th( 
discomfort caused by their unresolved guilt. 

And in conclusion the author says : 

A nineteenth-century physician Abraham Coles, wrote o 
"the inappeasable Nemesis within." He was speaking of th( 
guilty conscience. In this way the individual meets his owi 
guilt feelings; ideas of retribution may figure strongly. Patient 
require psychotherapeutic help, both for their psychosomatii 
ailments and for alleviation of such fears as may be explainec 
away. In obsessional cases or in severe instances in which thi 
concept of retribution affects all phases of the patient's living 
referral for psychiatric treatment is needed (p. 17). 

If the reader senses some ambiguity here, it will not b( 
surprising. What is the author really saying? On the on( 
hand, he seems to be saying, or at least implying, that ii 
neurosis, guilt is (always?) real, with a justifiable expecta 
tion of impending punishment or retribution of som( 
sort. But also he is suggesting that such fears may some 
times be "explained away"; and if not, that they can b( 
dealt with by established psychiatric methods. It is no 
clear what methods modern psychiatry has for dealing 
with real guilt. But the title of this article at least carrie: 
the implication that restitution might be an alternative 

Protestantism: ii. Challenge and Change 201 

the retribution which is often associated with neurotic 
endencies. Here is a new trend in contemporary psy- 
chiatric thought, which is further underscored by the 
following lines, quoted by the author, from Byron's 
'Childe Harold's Pilgrimage": 

Meantime I seek no sympathies, nor need; 
The thorns which I have reap'd are of the 

I planted, — they have torn me — and I 

I should have known what fruit would 

spring from such a seed. 

It sounds as if at least some psychiatrists are beginning 
:o take guilt seriously. This is a hopeful and constructive 

VI. confession: sacrament or therapy? — 

THE catholic POSITION 


In the Catholic Church, confession and the associated 
acts of contrition and attrition (remorse and penance) 
are first and foremost a sacrament: means, that is, of 
bringing one's immortal soul from a state of sin to grace 
and thus averting the dangers of Hell. But on the ques- 
tion of whether confession is also emotionally and psy- 
chologically helpful in this life, the Church is officially 
silent, with the views of individual Catholic writers cov- 
ering the full spectrum from strong affirmation to em- 
phatic denial. 

If present presuppositions are valid, confession and 
jpenance should — and in many instances rather clearly do 
! — ^have a genuinely hygienic effect, limitations in the 
|Catholic system notwithstanding. And among those who. 
Within the Church, emphasize this aspect of the practice, 
inone is more urgent and eloquent than Father Alfred 
fWilson, C. P., in his book Pardon and Peace (1954). 
IWorthy of close study in its entirety, this work (''Nihil 
'obstaf') can here be considered only in the most cursory 
fashion. But the author, having paid his respects to the 
sacramental aspect of confession, comes quickly and 
'clearly to his central thesis, which is that confession is 
unmistakably and powerfully therapeutic. He says: 

202 The Crisis in Psychiatry and Religion 

Our unfortunate non-Catholic brethren do not know what 
they are missing, and little realize the blessings that heresy 
has snatched from them (p. 2). 

No one goes to the doctor or the dentist for fun, unless 
he is mad. No one goes to Confession for fun. From the na- 
ture of the case, confession cannot be easy. The result, not 
the process, of confession is consoling. 

After serious sin, however, we have no alternative but to 
confess if we desire to regain undisturbed peace of mind 
and safeguard our sanity. We must lift the burden from our 
minds, or become a burden to ourselves and risk becoming 
a burden to others. Confession is then — if you like to put 
it that way — the lesser of two evils (p. 3). 

Why is this relief necessary? Why must we tell our misery 
to at least one representative of the human race? Because 
until we confess we feel hypocrites. We feel that we are 
being taken for a hundred percent good and we know we 
are not. We feel that we are obtaining respect and love un- 
der false pretences. If, however, we can find one member 
of the human race who will listen to us sympathetically, who 
can know the worst and still respect and love us, we feel that 
our self-respect and social status are somehow restored. We 
can then reasonably hope for the respect of our fellow-men, 
despite our fault. 

Sin sets up in the mind a conflict between our self-respect 
and our social sense. That conflict can be terminated only 
by some form of confession. "Confess, therefore, your sins 
one to another that you may be healed" (p. 5). 

There then follow some well-chosen phrases especially 
meant for Protestant ears: 

Confession is the only remedy. It is no use to say, as many 
non-Catholics do: *'I confess my sins directly to God, and 
that is quite good enough for me." First of all, it is the 
common experience that confession to God alone does not 
bring the fullest measure of relief of mind. It is no argument 
against this to say that it is not your experience. It is the 
common experience, and it is safe to presume that Christ 
legislated for the rule and not the exception. 

In any case, adequate mental readjustment after sin re- 
quires readjustment of our relations with our fellow-men as 
well as with God. If you insult a friend, it is not enough to 
apologize to God — ^you must apologize to your friend as well. 
. . . Sin is an offense against society as well as against God, 
and for both offenses adequate reparation must be made. . . . 

All these unrealists (who pout incessantly and suspiciously 

Protestantism: ii. Challenge and Change 203 

about their realism) are heading for a nervous breakdown 
(p. 6). 

And then, again in a more general vein, Father Wilson 

Confession of serious sin is necessary for the restoration 
of health of mind and soul, redundantly, even for health 
of body. "Suppressed sin, like suppressed steam, is dangerous. 
Confession is the safety-valve" (Weatherhead, 1929, p. 88). 

Modern psychologists have rediscovered this. They have 
found from practical experience that many nervous break- 
downs can be traced to a sense of guilt from unconfided and 
unforgiven sins (p. 8). 

I don't think the majority of Catholics realize how much 
they owe to the Sacrament of Penance. One of the greatest 
of Viennese psychologists, a man bitterly anti-Catholic [pre- 
sumably Freud], had the honesty to admit that, among his 
cases of serious psychological disorder, he had never had 
a genuinely practising Catholic (p. 10). 

Now, in stark contrast, we turn to a recent article by 
father Richard P. Vaughn, S. J., entitled "Mental Illness 
mong Religious." Here the whole emphasis of the Wil- 
on book upon the relationship between unredeemed sin 
nd emotional disturbance is flatly repudiated: 

In spite of research data to the contrary, there still persists 
a vague suspicion that mental illness is in some way con- 
nected with a sinful life or at least that it cannot occur if a 
person is leading a truly holy life. 

A psychosis is a type of sickness, just as are ulcers of the 
stomach or cirrhosis of the liver. Whether the cause of the 
psychotic condition is psychological or organic or a combina- 
tion of both (which is more likely) has not yet been estab- 
lished. It can, however, safely be stated that a psychosis 
(with the exception, perhaps, of a condition brought on by 
alcoholism or drug addiction) is not the result of a sinful 
life. The idea that it is the effect of sin is simply a remnant 
of past attitudes which still prevail from an era when little 
was known about psychiatry and psychology. The fact, there- 
fore, that a religious person becomes psychotic does not in 
any way imply past moral indiscretions. Religious,'' even 
though they follow a more perfect way of hfe, are no more 

' "Religous" is the Catholic term for persons who have taken 
loly Orders. 

204 The Crisis in Psychiatry and Religion 

immune from severe mental illness than the average lay per- 
son (pp. 27-28). 

What a remarkable exhibit! Despite the ancient and 
widespread folk belief that there is a connection between 
moral integrity and psychological integration, and despite 
the obvious advantage which accrues to Catholicism if it 
can be successfully maintained that confession is mentally 
hygienic (as well as sacramental), here is a Jesuit se- 
riously and insistently arguing against this position. The 
reason for his discomfiture is, however, not far to seek: 
it is impossible to verify the effectiveness or ineffective- 
ness of confession as a sacrament, and the Church can 
continue to make great metaphysical claims for it without 
fear of empirical refutation; but as soon as one makes a 
claim for confession as an instrument of either preven- 
tion or treatment, such a claim immediately becomes 
susceptible to empirical check — and it is already known 
that the facts on this score are somewhat ambiguous. 
Wilson, as we have seen, implies that confession, as pre- 
scribed by and practiced within the Church, is virtually 
a panacea as far as emotional and psychological disturb- 
ances are concerned; whereas Vaughn is equally emphatic 
and categorical in holding that there is no connection here 
at all! The truth probably lies somewhere in between; but 
with its doctrine of infallibility, the Church must, of 
course, take an all-or-none position — partially effective 
measures not being admissible. Yet, as it functions today, 
confession apparently has precisely this status, psychologi- 
cally speaking: although it is or, at least under the most 
favorable conditions, can be a decided aid to mental 
health, the mere formal observance of the rules govern- 
ing confession is no guarantee thereof; and the Church, 
some v^iters apparently feel, cannot afford to lay claim 
to any power which is not absolute. 

The situation is further illuminated if we note that in 
writing for and about religious laymen, as Father Wilson 
obviously did, it can always be argued that if a Catholic 
encounters intractable emotional difficulties, this is be- 
cause he has in some vital respect failed as a Catholic — 
and I am personally persuaded that there is some merit in 
this argument. But once a man or woman has taken Holy 
OrderSf the situation, per theory at least, is importantly 

Protestantism: ii. Challenge and Change 205 

modified. Here are the best, "the religious/* an elite 
guard, in whom human frailties have been all but van- 
quished; and the fact, indeed prevalencey of serious men- 
tal disorder among monastics (especially women) is well 
established (cf. Moore, 1936) . This problem is, indeed, so 
serious that Father Vaughn pleads for ''psychological 
screening" of individuals entering the orders: 

Many a community has spent thousands of dollars for the 
hospitalization of a single psychotic member, and this at con- 
siderable sacrifice to the other members of the community. 
And then after all this expense, it not infrequently happens 
that the religious is finally diagnosed as incurable. In such 
cases one might well ask whether such a diagnosis would 
have been reached if the psychotic religious had never been 
subjected to the strain and disillusionment of the religious 
life (p. 29). 

Here is an oblique admission that at least for those 
entering the special orders, Catholicism, far from being 
therapeutic, may have exactly the opposite influence. It 
is little wonder, therefore, that this whole matter is at 
present a very painful and confusing one for the Church, 
from top to bottom. The ambiguity of the situation is, in 
fact, excellently portrayed by a current article on "Sin, 
Sickness, and Psychiatry," by John R. Connery, S. J., 
which appears in America, the official Jesuit journal of 
opinion and controversy. Here the author says, by way of 
introduction : 

The various aspects of this conflict are best illustrated in 
the different opinions advanced regarding the relationship 
between sin and mental sickness. Besides the opinion that 
would regard sin as sickness rather than an expression of the 
will of the sinner, there is a second opinion that, surprisingly, 
reverses the relationship. According to this opinion, sin, far 
from being the result, is really the cause of mental illness. A 
third opinion refuses to consider sin either as cause or effect 
of mental illness, but tends to regard it as the cure (p. 493). 

It is, of course, not surprising that the author of this 
article should reject the first and third of these hy- 
potheses. The Church, obviously, cannot concede either 
that sin is an expression of psychopathology or that it is 
a cure thereof ["Have an affair!" "Act single!" cf.]. It 
is, of course, the second possibility, namely that uncon- 

206 The Crisis in Psychiatry and Religion 

fessed and unexpiated sin is the cause of psychopathology 
that gives Cathohc theorists the difficulty. Connery ad- 
mits that: 

It is quite true that the act of confessing one's sins, the 
acceptance of the priest and of his pastoral counsel can 
have some therapeutic value, but this is not the primary pur- 
pose for which the sacrament was instituted. The sacrament 
of penance is primarily a sacrament of forgiveness (p. 493). 

Then the author tries to come more specifically to grips 
with the hypothesis that "neurosis must be traced to 
sin." He says: 

According to this opinion, it is because the patient has 
repressed his conscience, rather than because he has repressed 
his instinctive drives, that he develops a neurosis. Although 
this position is held by some first-rate psychologists and psy- 
chiatrists, it is vigorously opposed by equally competent repre- 
sentatives of these fields. From a religious viewpoint it does 
not have the objectionable features of the opinions already 
considered, but it is not necessarily true because it is reli- 
giously more agreeable. There are, indeed, good reasons for 
questioning it. First of all, there are many habitual sinners 
who to all appearances have average mental and emotional 
balance. Secondly, the scrupulous conscience, which usually 
must be classified as neurotic to some degree, does not ordi- 
narily have its origin in past sin. For the most part, the scru- 
pulous individual is as remote from sin as one can get (p. 

This is an incompetent and irresponsible statement. 
The argument that, because all persons w^ho are sinners 
are not mentally disturbed, there is no relation at all be- 
tween sin and insanity is a classical non sequitur which 
I have discussed elsewhere [Chapter 1 3] . And in the same 
connection I have cited evidence (as well as another 
Catholic authority— Stafford, 1950) for the view that 
scrupulosity is a neurosis precisely because the individual 
so afflicted prefers this symptom to an honest and thor- 
oughgoing confession. 

No, the plain truth is that most Catholic writers do 
not wish to recognize neurosis as a basically moral and 
social problem, because they realize that to do so raises 
embarrassing questions concerning the adequacy of 
Catholic doctrine and practice, thus underscoring the 

Protestantism: ii. Challenge and Change 207 

specific limitations and criticisms which I have enumer- 
ated in Section IV. Here, therefore, is a wonderful op- 
portunity and challenge to other religious groups: to 
develop ways of dealing with personal guilt which are 
genuinely adequate, psychologically and ethically, and 
which do not retreat into the realm of metaphysical 
claims which defy verification. It is also an opportunity 
for Catholicism to take stock of itself and institute some 
long overdue reforms. 

A curious but not uninstructive drawing accompanies 
the article by Father Connery, which is also reproduced 
here. What does it mean? I hold it expresses the am- 
biguity, the confusion, the sickness of the contemporary 
Catholic position in this whole matter of sin and psy- 
choneuroses. The figure, ostensibly a monk, is caught in 

208 The Crisis in Psychiatry and Religion 

a posture which is both rehgious and schizophrenic. The 
Church, which has a conscience, is sore afflicted because 
it is refusing to minister to anxious, depressed people for 
fear of compromising or having to modify its doctrinal 
pretensions. If the Church is so rigid and fixated that it 
cannot act as a physician to itself, the necessary accom- 
modations and changes must be made, as before, outside 
the Church. 


With issues as global and controversial as those with 
which we have dealt in these two lectures, it is easy to 
doubt, at times, the validity of one's most basic assump- 
tions. There is no simple, direct way of testing or demon- 
strating them — to others or, indeed, to oneself; and when 
they represent a marked departure from ordinary beliefs, 
one wonders, occasionally, if they may not be sheer 
fantasy. There is, however, a stark reality to which I 
return in my doubting and always find grimly reassuring. 
In an era in which physical disease has been spectacularly 
reduced, the indices of personality disorder, by contrast, 
have steadily risen. In the two decades between 1934 
and 1954, the death rate in this country declined 13.6% 
(Fagley, 1960, p. 29); but during this same period the 
likelihood of one's spending some part of his life in a 
mental hospital — the abode of the ^'living dead" — rose 
from about one in 20 to one in 10. The evidence that 
prevailing views and practices in this area are seriously 
inadequate is thus compelling. And at least small signs 
keep emerging which point in the direction of alternatives 
which seem more promising. 

Following a lecture which I gave a few months ago in 
a city in Northern California, a diffident but obviously 
intelligent middle-aged woman approached me and said 
that she thought I might like to know that the Church 
of the Latter Day Saints has always placed a great deal 
of emphasis upon good deeds — in contrast to the Pauline 
doctrine of justification by faith — and, as a result, has 
been a constant target for criticism by Protestant the- 
ologians. This bit of information did indeed interest me; 
and somewhat later I happened to mention it to a social 
worker who, himself a Mormon, volunteered the addi- 

Protestantism: ii. Challenge and Change 209 

tional information that his rehgion sets aside one Sunday 
each month for open confession. Then he mentioned a 
case history recently reported to him by a non-Mormon 
chnical psychologist known to both of us which indicates 
the possible therapeutic effectiveness of the Mormon ap- 
proach in these matters. I immediately wrote for further 
details; and the psychologist obligingly supplied a copy 
of the "Social Service Intake" record and of his own 
"Termination Note." The first of these documents reads 
as follows: 

This 21 -year-old female is referred by Dr. because 

of anxiety over sexual adjustment, brought about by long- 
standing unsatisfactory sexual relationships with her father. 
She is a rather large, plump girl who brings a long tale of se- 
duction and mistreatment by her father since approximately 
age 7. She is not a particularly verbal girl, and did not volun- 
teer much during the interview. She has been going with a boy 
for approximately six months, has thought of marriage, but 
is physically repelled by him. She states that sex is associated 
in her mind with sin and pain, and that she would like help 
to relieve these feelings. Her conversation was flat and unemo- 
tional throughout the interview, and she has a rather placid, 
unemotional face. 

Patient is the oldest of four children, having a full sister, 
a half sister, and a half brother. The patient's mother died 
when she was four years of age and the father remarried 

about four years later. is a daughter by the stepmother's 

first marriage, and is a son by the present mother and 


The patient states that the father has forced sexual rela- 
tionships on her and her two sisters since the patient was 7 
years of age, that he has been extremely abusive toward her, 
that he has never shown any affection except when sexually 
aroused, and that she has come to think of men as being 
brutal persons who want nothing but physical satisfaction 
from their women. She was particularly irked by the fact 
that her father played favorites, and was frequently quite 
seductive toward her sisters in her presence. She has tried to 
work out her problems with her boy friend's help, but feels 
intensely frigid toward him when he becomes affectionate. 
I Her general attitude toward sex has been that it is dirty, and 
j it has been with effort that she has associated with boys, 
usually preferring and feeling more comfortable with girls as 

Currently, the father is at Psychopathic Hospital 

undergoing psychiatric evaluation, since the girls filed a com- 

210 The Crisis in Psychiatry and Religion 

plaint with the County Insane Commission.* The patient 
reports that he has been increasingly abusive, suspicious, 
jealous, and demanding of his daughters. Matters reached a 
head this spring when the patient returned from her third i 
year of college and refused her father's advances. Currently,] 
the stepmother is attempting to defend him legally. Thej 
patient's impression is that the stepmother has known about j 
these affairs for many years, but that she has not wanted' 
to do anything about them. i 

has problems connected with a long-term unsatisfactory rela- 
tionship with her father. It is understandable that she 
should equate sex with brutality, and that there should be a 
distortion in her relationship with men. Significantly, she 
suspects men of seductive motivations to the extent that she 
expressed a fear that I might attempt to "seduce" her. It 
had not occurred to her that such a possibility in a setting 
like this would be totally unrealistic. There is a question in 
my mind in regard to her motivation for therapy, but this 
impression may be imposed by her rather flat manner and 
affects. The patient should be seen for psychiatric evaluation, 
and should probably be scheduled for full psychological ex- 
amination at an early date. This does not appear to be an 
emergency case, and could be placed on our waiting list 
following the diagnostic studies. 

Executive Director 

* The father was given a long prison sentence subsequent to 
this evaluation. 

This case has many interesting implications and is 
especially pertinent to the present discussion. It is clear 
that this young woman's guilt concerning the incest 
was a barrier to normal marriage and that her coming to 
the clinic was prompted by the fact that she had become 
of marriageable age and had some prospects. She felt — 
quite understandably — that she could not get married 
with the incest on her conscience; and she was forthright 
in saying that she * 'would like help to relieve these feel- 

The intake worker reports that the client — ^let us call 
her Marie — "has come to think of men as being brutal 
persons who want nothing but physical satisfaction from 
their women," thus implicitly shifting blame and partially 
rationalizing her own conduct^and somewhat becloud- 

Protestantism: ii. Challenge and Change 211 

ing the reason why she can't get married. But if there 
were not deep guilt and self-rejection in the situation, 
it seems that the early introduction to sex and prolonged 
experience with it would have paved the way for con- 
tinuation with others. Instead, *'sex is associated in her 
mind with sin and pain." Also it is noteworthy that 
Marie, while intimating that the stepmother knew of the 
incest, gives no indication of ever having appealed to 
her for help. If there had been no complicity in the 
situation, it seems there would have been a complaint 
or protest, to someone! 

On another occasion [Chapter 8], I have discussed 
the deep incest guilt of a schizoid girl known as Joan. 
But in situations where frank psychopathology is present, 
a skeptic can always dismiss the incest — and, therefore, 
real guilt as the cause of the "illness" — as a fabrication 
or "delusion" or can interpret the act, if real, as an early 
expression of the disease itself. (In fact, the counselor 
who initially reported the Joan case, anonymously, has 
recently written to me and expressed — apparently for 
theoretical rather than empirical reasons — some doubt of 
the validity of Joan's report of the experiences with her 
father. ) But in the present situation, there is no question 
of "schizophrenia" or any other well developed mental 
disease; and the fact of the incest seems established 
beyond doubt (cf. the prison term given to the father 
for the offense). Hence, the "dynamics" of the case seem 
particularly clear, unambiguous, and instructive. 

Let us now examine the "Termination Note" dictated 
and generously provided by the psychologist to whom 
Marie was assigned: 

Marie was referred by Dr. in September, 1957, be- 
cause of extreme fears regarding sexual relations, in part 
stemming from long-term incestuous relations with her father. 
She was seen for a total of 12 interviews (primarily psy- 
chotherapeutically) from November 31, 1957, to April 19, 
1958. Marie is being terminated since she will be leaving for 

to obtain work and probably resume College after a 


Marie had a very strong fear of the close relationship with 
a man in psychotherapy which resulted in her extreme tension 
with me at the beginning of the treatment process, wanting 
to quit treatment several times, and finding different excuses 
not to make regularly scheduled appointments. At first my 

212 The Crisis in Psychiatry and Religion 

interest in her was interpreted by her as having sexual imphca- 
tions. Slow and careful work with her resulted in excellent 
progress for the relatively few short interviews considering 
the nature of her problem. Marie has begun to show greater 
initiative and less extreme submissiveness; there was a definite 
decrease in her extreme feelings of being "so different and 
so inadequate," now she can allow herself to try many things, 
whereas before she would have been convinced prior to any 
attempt that she could not accomplish the task. There was 
the beginning of a greater feeling of being at ease with all 
people including men, plus less sinful and guilty feelings re- 
garding sex. She was able to lose weight more quickly than 
ever before in her life, probably a reflection of her decrease 
in fear of being attractive to men. 

However, though the progress was excellent, it is felt that 
much more psychotherapy need be undertaken prior to her 
ability to deeply enjoy a close relationship with a man, such 
as in marriage. We had just begun to directly work on the 
very disturbing sexual area when Marie got this fine oppor- 
tunity to go to and live with persons whom she felt at 

home with in her new-found religion, that of the Latter-Day 

Her definite need for further treatment when she gets to 

appeared to be fairly well emotionally accepted by 

Marie. Perhaps more than any insight, the one thing that 
was most helpful to her was the beginning of the develop- 
ment of some deep trust in one man. However, whoever 
works with her in psychotherapy should anticipate a pretty 
stormy relationship with her, including such things as want- 
ing to terminate treatment many times, and finding excuses 
for not coming to interiews. 
TYPE OF service: Diaguosis and treatment. 
diagnosis: Phobic reaction (intense fear of close relationship 
with all men) in a passive-aggressive personality, passive- 
dependent type. 
disposition: Patient withdrew from Clinic service. Clinic 

notified, (moved) 
prognosis: Good for continuation of above described gains; 
need for further psychotherapy after she moves. 

, Ph.D. 

Chief Psychologist 

The orientation of the staff of the clinic to which 
Marie resorted for help was rather clearly Freudian; and 
we may conjecture that in therapy an attempt was made 
to get her to feel that not all men were like her father 

Protestantism: ii. Challenge and Change 213 

md that she therefore had no justified reason to fear 
them — and sexual relations. But if we assume, as we rea- 
ionably may, that Marie's problem was not simply one of 
traumatic conditioning against sex but rather an incon- 
testable personal guilt, then her *'fear of men" (as author- 
ity figures) was justified, in a very different way; and sens- 
ing that the therapy was not addressed precisely to her 
[leed, it is perhaps not surprising that Marie was restive, 
dissatisfied, and eventually "withdrew." A letter from the 
:herapist, which accompanied the materials already 
presented, is particularly illuminating. It reads, in part, as 

I am happy to share with you some details of the case of 
a young womaiTwith whom I worked and for whom the 
membership in the Mormon Church seemed to be a con- 
structive change. . . . This young woman had been a mem- 
ber of a fundamentalist Protestant church, in which she ap- 
parently frequently felt terribly guilty when she was present 
at their services. I have the feeling that therapy may have 
helped her to reduce enough of the neurotic guilt so that 
she was able to seek out a religion, which was guilt reducing, 
paternalistic and supportive, the Mormon religion. Then 
perhaps the Mormon religion in turn is helping her to reduce 
the neurotic guilt and thus handle normal guilt, and life in 
general, more constructively. 

It is not clear why reference is made here to "neurotic" 
^uilt. Surely the assumption is not that this young woman 
should have emerged from her situation with no guilt, 
or that the guilt she felt was unjustified or dispropor- 
tionate. The circumstances were, to be sure, somewhat 
Extenuating; and it is much to the girl's credit that she 
Eventually took it upon herself to do what she could to 
rectify matters. But it is hard to see how anyone with 
Even a semblance of character and social awareness could 
have gone through what this girl had and be more normal 
or symptom-free. Here, if it was ever the case, guilt was 
a facty a tragic and inescapable reality, and not just a 
"neurotic" feeling. And it is no accident, surely, that 
secular therapy was characterized by the girl's "wanting 
to terminate treatment many times, and finding excuses 
for not coming to the interviews." We can hardly escape 
the inference that she sensed her problem was not 
understood and that no real help would be forthcoming. 

214 The Crisis in Psychiatry and Religion 

Here we also have an excellent example of the com- 
mon failure of Protestant churches to cope with desperate 
personal guilt on the part of its members. There is no 
indication that this girl went to her minister about her 
problem at all; and if she had, the chances are he would 
either have been horrified and made a quite nonfunc- 
tional scene of some sort or, if more considerate, would 
have immediately admonished the girl to ''seek God's 
forgiveness in prayer." If, on the other hand, the church 
had been liberal (rather than Fundamentalist), the 
minister might have tried to be more enlightened and 
to "counsel" with her along essentially secular lines, 
with a reaction similar to the one she gave to the therapy 
she received at the clinic. 

The moral of this case is, therefore, clear: it indicates 
that neither Protestant theology nor Freudian psychology 
is at all adequate to the needs of deeply guilty people 
and that we must instead seek and utilize the healing 
power of human community and good deeds, rather than 
ignore and despise them. 

VIII. confession, community, and character 

In February, 1960, I spent a few days on the campus 
of the State College at Corvallis, Oregon, and while 
there Professor Lester A. Kirkendall told me of the fol- 
lowing observation. Professor Kirkendall has done a great 
deal of counseling with college students, particularly 
with young men; and over the years he says he has found 
a striking correlation between a student's general social 
adjustment and the degree of normality in his sex life. 
If the man has good social relations, the chances are 
very high that he will report no serious conflict, perver- 
sion, or the like in the sexual realm. But if there is 
seclusiveness and uneasiness with people, there is likely 
to be some anomaly in the matter of sex. 

Intuitively this relationship is not surprising, but it 
is useful to look at it somewhat more analytically. If 
there is perversity or evil in a man's sexual practices, it 
stands to reason that he should be socially ill at ease: 
if he has any character at all, he will, as a matter of 
course, feel guilty and will be uncomfortable in the 
presence of others. But this perception of the situation, 

Protestantism: ii. Challenge and Change 215 

valid as it probably is, leaves unanswered the question 
of why some young men are sexually normal, others 
perverse and deviant. Dr. Kirkendall is inclined to believe, 
and I certainly share his impression, that good control 
in the matter of sex is most likely to be achieved in an 
individual who, as a matter of policy and habit, is 
socially open, has a strong sense of community, and 
shuns secrecy and duplicity. 

We are likely to think of strength of character and 
so-called will power as something we have or exercise 
deep down inside us. And we are likely to try to improve 
this capacity in others by admonishing, scolding, lectur- 
ing them. I am increasingly persuaded that will power 
or self-control is not nearly so much of an individual 
matter as we sometimes think. Instead, is it not basically 
a social phenomenon? Here, in society, is where the 
norms and values reside, and the person whose life is 
open to social interaction and influence has the benefit 
of social supports and sanctions. But the individual who 
embarks upon a policy of covertness and secrecy does not 
have this source of strength and soon finds himself the 
victim of uncontrollable temptation and, as he is likely 
to experience it, a "weak will." Superficially, the diffi- 
culty lies in the area of his sexual drives and practices; 
but more fundamentally the problem is one of . social 
integration or the lack of it. 

The pertinence of confession and community here is 
obvious. A few years ago I was discussing this general 
problem in a summer-school class, and a student spoke 
up and said that some of the banks in Chicago regularly 
give their employees lie detection tests. Not immediately 
seeing the point of this comment, I must have looked 
a trifle puzzled, so the student added: "It helps them 
stay honest." I then realized that the purpose of this 
procedure is not so much to detect anyone who has 
already done something wrong; rather it is to create a 
feeling that if anyone begins a dishonest practice, it will 
soon be known. This amounts, in effect, to periodic 
"confession." And if one knows that whatever he does 
is going to be known, one usually finds that he has the 
"will power" not to do it. Often we think of confession 
solely as a mechanism for relieving us of guilt associated 
with acts already committed. If confession is not made 

216 The Crisis in Psychiatry and Religion 

artificially easy, I am persuaded it has not only this 
redemptive function but also a strongly prophylactic one 
as well. 

Sin, as Bonhoeffer aptly observes, demands to have 
a man alone. As long as as a man is in community, in 
free and open touch with others, he will have a vivid 
sense of the consequences of wrong acts which gives him 
the strength, and wisdom, not to commit them — or, if 
he does, to move rapidly toward their rectification. But 
if he has committed himself to the path of hypocrisy, of 
being with people but not of them, he does not have 
this advantage and is almost certain to get into moral 
predicaments of one kind or another. 

The great Protestant emphasis has been, of course, 
not upon the relation of man to man but on the relation 
of man to God. By-pass human intermediaries and take 
our sins and concerns directly to God in prayer, that has 
been the sovereign Protestant strategy. For the morally 
and religiously well-developed person, I am sure this is 
often sufficient. The man of character so prizes a clear 
conscience and free communion with that immanent or 
transcendent something called God that he is extremely 
careful of his conduct, without any necessary reference 
to whether it will or will not be known to others. But 
this is the end, not the means, of a long developmental 
process. In children openness and integrity have to be 
taught and experienced first in the context of the family; 
and when, in an adult, there is an inadequacy or failure 
of character, personal reconstruction seems far more 
likely to occur in the horizontal than in the purely 
vertical dimension. 

What is the place of ordinary church attendance and 
public worship in the lives of men and women? Again, 
for the religiously and morally mature and the emo- 
tionally healthy, I have no doubt that corporate confes- 
sion is helpful and ordinarily sufficient. But in extraor- 
dinary circumstances, it is often seriously inadequate 
and urgently needs to be supplemented by procedures 
which are generally lacking in the typical Protestant 

One of the great problems of our time is said to be 
that the average man doesn't "know who he is." This 
is a sign of neuroticism. Feelings of depersonalization and 

Protestantism: ii. Challenge and Change 217 

a sense of unreality are typical of the experience of 
severely disturbed persons. How else would we expect 
it to be? If our thesis be correct, the essence of psycho- 
pathology is systematic denial of who one is; and if we 
misrepresent ourselves to others, it is not surprising that 
we soon begin to appear alien, strange, and ''unfamiliar" 
even to ourselves. Francis Thompson ends the first stanza 
of his great religious poem The Hound of Heaven with 
the trenchant thought, "All things betray thee who 
betrayest me." We cannot, it seems, escape the fact that 
we can be true to ourselves only if we are first true to 
others. At a very profound level, Shakespeare was right, 
of course, when he said that if we are true to ourselves 
we cannot be false to any man. That is to say, one's 
own long-term self-interest is consistent with his social 
interest. But in ordinary day-to-day practice, we are 
undoubtedly on sounder ground if we seek to find our- 
selves in the life of the group than if we attempt to 
fashion the group according to our own image and 


Increasingly it appears that the central fact in per- 
sonality disorder is real guilt and that it can be radically 
resolved only by confession that has at least a quasi-public 
character. But, as we have seen [cf. Chapters 4, 5, 8, 
and 13], this always involves, at least in well developed 
personalities, the danger of a catastrophic reaction, which 
may take the form of psychosis, suicide, or other forms 
of ''acting-out." Assurance of God's love, grace, and 
forgiveness are to no avail in such a crisis. What, then, 
should clergymen do in the face of an eventuality of this 
kind? Here I have only tentative suggestions to offer; 
but I am convinced that sound and effective measures 
can and will be found if religious leaders and dedicated 
laymen take seriously the moral basis of personality dis- 
turbance and allow themselves to feel the full force of 
the responsibility which thus logically devolves upon 
them. My suggestions, listed more or less randomly, are 

1. Clergymen and pastoral counselors need to have at 

218 The Crisis in Psychiatry and Religion 

their disposal facilities for providing continuous care and 
supervision for persons during periods of acute disturb- 
ance. If the acute stages of a personality crisis can be 
handled in this way, more protracted institutionalization 
can, I believe, often be avoided. I know a church in 
Philadelphia which is in the process of establishing such 
a facility, to be staffed, as occasion requires, by regular 
church members, its ministers, and Christian physicians. 

2. A special effort should be made to elicit the interest 
and assistance of persons who have themselves had per- 
sonality disturbances and have made a good recovery 
therefrom. They are likely to have less fear of other 
disturbed individuals than does the ordinary person; and 
they often also have deep insights and are highly mo- 
tivated. Care of and concern for others is powerfully 
therapeutic in its own right. 

3. Ministers need to band together in their community 
for a sort of "group practice." In this way the individual 
counselor can be made both more cautious and more 
courageous, with group consultation and supervision 
available to him. A project in Kokomo, Indiana, which 
has been inaugurated by Granger Westberg, with sup- 
port from the Lilly Endowment, offers a model for this 
type of development. 

4. Ministers with specialized training and experience 
in counseling can be of great assistance in guiding, 
teaching, and supporting other ministers in their efforts 
in this area. Russell Dicks has recently established him- 
self, in a community in Florida, in a unique kind of 
"private practice." His plan is to accept referrals from 
other ministers and to deal with them, on a fee basis, 
while at the same time encouraging the ministers making 
the referrals to follow developments and thereby extend 
and improve their own competence. Such a procedure, 
if widely adopted, is almost certain to evoke a protest 
from the psychiatric profession (see Joint Committee 
on Relations between Psychology and Psychiatry, 1960). 
But if its effectiveness can be demonstrated, social and 
legal protection will follow. 

5. Young Protestant clergymen with whom I have 
recently talked complain of their "lack of authority" in 
dealing with problem persons. They lack, they say, the 
sanctions of both priest and physician and feel quite 

Protestantism: ii. Challenge and Change 219 

helpless in asserting any kind of decisive influence upon 
others in time of crisis. My conviction is that as their 
competence and confidence in this area grow, ministers 
will find that so also have "authority." Clinical psychol- 
ogists, in a somewhat similar predicament, have found 
that making continued psychotherapeutic contact con- 
tingent is often effective in inducing client compliance. 

6. The individual undergoing acute personal crisis 
needs to see the potentially constructive, growth-inducing 
potentialities of the experience. Here the writings of 
Anton T. Boisen can be particularly helpful. I believe 
in encouraging the disturbed person to see his situation 
as involving what Old Testament writers referred to as 
the Wrath of God. At the same time it should be pointed 
out that the Wrath of God is the form in which those 
who defy Hirn experience His Love. The chastisement 
of an unruly child by loving parents is a meaningful 

7. While accepting the self-condemning and self-pun- 
ishing tendencies of the "sick" individual as under- 
standable, reasonable, and even right in a certain sense, 
an effort should be made to help him move as rapidly 
as possible from expiation to restitution, from self-lacera- 
tion to a program of service, self-discipline, and meaning- 
ful sacrifice. In my judgment the reason electroshock 
convulsions are often "therapeutic" (especially in depres- 
sions) is that they aid and expedite the work of self- 
punishment. In the preceding lecture we have alluded 
to the extent to which charity has become secularized 
and, in a sense, even commercialized (as "insurance" of 
various kinds). In Zborowski and Herzog's recent book. 
Life Is with People, an interesting picture is given of 
traditional Jewish life in the now all but vanished "stetl" 
villages of Eastern Europe. There philanthropy was con- 
tinuously practiced, by almost everybody, as an everyday 
aspect of ongoing social and religious life. Many of the 
traditional occasions for generosity have, of course, dis- 
appeared in modern society; but there are always impor- 
tant and deserving "causes" to which one can contribute 
time and money. It is thus not so much the opportunity 
for generosity which has disappeared as the logical and 
psychological rationale therefor. The latter desperately 
needs to be recovered. 

220 The Crisis in Psychiatry and Religion 

8. The Apostle Paul has warned against attempted 
"justification" through good works, "lest any man should 
boast." Then let us not "boast" but rather make restitu- 
tion and perform good deeds without publicity and self- 
acclaim. Attempts to pray, analyze, or tranquilize our- 
selves out of sin have been ineffective. A more active 
form of "therapy" seems our only remaining option. 

Somewhat parenthetically I want to say that I am not 
unaware that the approach here proposed is at least super- 
ficially paradoxical: it might be characterized as a sort 
of irreligious religious approach to the problem of per- 
sonality disturbance. More accurately, one might say 
that the approach is actively religious but minimally 
theological in the conventional sense of that term. The 
approach is religious in the sense that it accepts the 
reality of unconfessed and unredeemed sin as central in 
psychopathology and holds confession and restitution to 
be commonly necessary for recovery. But it involves a 
minimal theological emphasis in that it stresses the 
interpersonal dimension as more crucial for therapeutic 
movement than the man-God relationship because it is 
the former that has been most palpably ruptured and can 
be repaired, in many instances, only by the individual's 
working hard at modifying and improving his everyday 

Some years ago I heard a Park Avenue minister, in 
New York, take the position that if man's relation with 
God goes wrong, he is soon in trouble with his fellow 
men, and that when this happens he is automatically in 
trouble with himself; so, by implication, the place to 
start "therapy" or redemption is in the vertical, man- 
God dimension. Empirically, this assumption does not 
seem to be well borne out. And the psychoanalytic as- 
sumption that we have to work on our relationship with 
ourselves has also been a disappointment. The possibility 
that remains is the interpersonal approach, and it is the 
one which is now attracting most interest from secular 
students of the problem. It is also the one which holds 
greatest promise of a genuine rapprochement between 
science and religion in this area. Dr. Gordon McKay, 
President of McCormick Theological Seminary, has a 
talk which he sometimes gives to ministers entitled, 
"Don't Pray Too Soon." I have not personally heard this 

Protestantism: ii. Challenge and Change 221 

talk, but Dr. McKay has recently written concerning it 
as follows: 

The general notion behind the talk is that prayer is too 
frequently employed as a substitute for action. Beyond that^ 
the resort to prayer is frequently among ministers little more 
than a cover-up for their ignorance and/or unwillingness to 
employ such community recourses as are available to serve 
the needs of men and women whose lives are blighted by 
such problems as alcoholism, marital discord, and mental 

It seems to me that a full understanding of the Pauline 
concept of salvation requires us to recall that Paul's strong 
insistence on justification by faith was always coupled with 
the admonition that we are to work out our salvation with 
fear and trembling. Every great theological discourse in Paul's 
writings is followed by a chapter or two on moral teaching. 

And recently I heard Dr. Roy Burkhart, of the First 
Community Church in Columbus, Ohio, say that salva- 
tion is a social operation. Certainly there is a growing 
disposition on the part of sensitive and perceptive clergy- 
men to emphasize this approach. It is, I believe, ex- 
tremely promising; and if metaphysical assumptions can 
be, at least for the time being, held in abeyance and a 
renewed emphasis put upon the interpersonal dimension, 
[ believe something of a "break-through" can be achieved. 


Footnotes to a Theory 
of Psychopathology"^ 

As the title indicates, this chapter repersents an attempt 
to pick up loose ends of fact and logic and tie them into 
the general argument with which this book is concerned. 
Here we see, again, the internal weaknesses of psycho- 
analysis, both as formal structure and as a^' system of 
practice, and the ambiguity of a theology which finds it 

Not long ago, in talking with a Lutheran minister, 
I remarked of a certain church practice that it might be 
theologically necessary and sufficient but that it was 
manifestly not psychologically adequate. To which my 
friend replied: ''In my opinion, if a practice is not psy- 
chologically adequate, it's not theologically adequate!" 
Here, surely, is a fine spirit, which can go far toward 
forging the new, unified conception of man in which we 
today stand in such need. But in this chapter we see, 
with special clarity, that before a valid synthesis of this 
kind can come about, we must have both a psychology 
and a theology which are in certain important respects 
different from what we have recently known. In other 
words, our explorations, here and in other chapters of 
this book, suggest reform in contemporary theology as^ 
well as in psychiatry and clinical psychology. 


In a series of recent papers [Chapters 2, 8, and 9], 
I have dehneated that conception of personahty dis- 
order which seems to me logically most compelling, em- 
pirically best supported, and therefore most promising 
in terms of new and more radically effective methods of 
personal (and social) reconstruction. Here it will be 

* Presented April 20, 1960, before the Los Angeles Society of 
Neurology and Psychiatry and independently published in 
Progress in Clinical Psychology (D. Biower & L. E. Abt, edi- 
tors), Grune & Stratton, 1960. 

222 i 

\ Theory of Psychopathology 223 

leither possible nor necessary to restate that conception 
n any comprehensive way. Instead, the present paper 
vill take for granted a general familiarity with this 
:heoretical framework and will advance some additional 
considerations in the nature of footnotes or marginal 
ottings and comment. 


Viewed in retrospect, how truly remarkable was that 
conception of psychopathology which dominated theory 
md practice two or three decades ago! Genuine guilt, 
ustified self-loathing, and realistic interpersonal uneasi- 
less were given little or no weight in the genesis of the 
o-called psychoneuroses, where false conscientiousness 
vas assumed to be capable of playing veritable havoc, 
n other words, a supposedly overly severe superego, 
temming from unduly strict childhood training and 
otally unsupported by ongoing experience and social 
)r legal realities, was assumed to be more powerful and 
herefore more likely to disturb or destroy our peace of 
nind than was a sound, realistic, normal conscience 
vhich the individual had outraged by engaging in palpa- 
)le, unacknowledged, and unredeemed misconduct. Such 
I thesis is clearly contrary to common sense and what we 
enow about the principles of reinforcement and extinc- 
:ion (in learning theory) and is controverted by all sorts 
)f clinical evidence; yet it was seized upon and pro- 
laimed as a great scientific discovery and cultural achieve- 

Now, within the last five or ten years, the picture 
las changed considerably. No longer is it maintained 
:hat the Freudian doctrine is universally applicable but 
)nly, perhaps, in some cases. For example, Jourard 
[1958) interprets the present situation as follows: 

Clinical experience suggests that neither Freud nor Mowrer 
is wholly correct or wholly incorrect. Rather, it can be found 
that some neurotic patients do indeed have a conscience 
that is too strict; in order to remain guilt-free, they must 
refrain from all pleasurable activities, including those which 
society condones. Other patients may be found with the 
makeup which Mowrer has regarded as nuclear to all neurosis 

224 The Crisis in Psychiatry and Religion 

— they repress conscience so they can break social taboos 
without conscious guilt (p. 366). 

This is not necessarily an illogical position, but there 
is reason to doubt its factual validity. If, a generation 
ago, psychoanalysts were unable to recognize the presence 
and operation of real guilt in persons fairly devastated 
by it and so treated everyone as if they suffered only from 
false guilt, why should we now trust them to make 
exactly the right distinction between the two classes of 
'"neurotics" which Jourard and many others are today 
suggesting? Diametrically opposed types of "therapy" 
would presumably be called for in the two different sit- 
uations; and it is of some importance, obviously, that the 
^'differential diagnosis" be made with precision and dis- 
cernment. In the one instance, the goal of therapy pre- 
sumably remains that of reducing the severity of the 
superego, i.e., attempting to close the painful discrepancy 
between a person's moral aspirations and his perform- 
ance by lowering the level of the moral aspirations; 
whereas, in the other situation, the therapeutic objective 
is that of helping the patient become a better person, 
i.e., to improve and raise the level of his performance. 

When did psychoanalysts or, for that matter, secular 
therapists in general, acquire special skill and competence 
along these latter lines? Their formal professional train- 
ing and theoretical orientation has been almost exclu- 
sively in the reverse direction. When did they sud- 
denly discover, if they have, that they are also uniquely 
equipped to work with this other type of personality 
disturbance? Even if the secular therapist were wise 
enough to be able to tell in advance of treatment ("diag- 
nostically") whether a given person falls into the one 
category or the other, and even though he admitted he 
had no special competence in dealing with the individual 
suffering from real guilt, there is still an interesting ques- 
tion as to what he would then do with such persons. 
When the secular therapist today discovers that a patient 
is suffering from a genuine moral dilemma or ambiguity, 
rather than an imaginary ("neurotic") one, what does 
he typically do — meticulously "refer" such a person to 
pastoral counselors? Are secular therapists, who in the 
past were so insistent that parish ministers and chaplains 

. Theory of Psychopathology 225 

jcognize their "limitations" and know when to "refer," 
ow recognizing their own hmitations and making coun- 
;r-referrals? Or is the flow, for economic reasons, still 
irgely in the one direction? 

We cannot here hope to settle the question as to 
hether there is indeed a residual class of persons who, 
Freud insisted, suffer from over-conscientiousness, 
ither than justified and realistic pangs of conscience.^ 

^A somewhat different way of approaching this problem has 

;en suggested by Dr. H. J. Eysenck in his book, The Dyna- 

ics of Anxiety and Hysteria: "In closing this chapter [on 

acialization and Personality] we may fittingly return to the 

ifference in opinion we noted in our second chapter between 

lowrer on the one hand and Dollard & Miller [1950] on the 

fcher. It will be remembered that in their theories of neurosis 

lese writers were in sharp contradiction, Mowrer advocating 

theory according to which the Id was too powerful as opposed 

i) the Super-Ego, while Dollard & Miller [with Freud] advo- 

ated a theory according to which the Super-Ego was too 

erful as opposed to the Id. We can now see that these 

heories are relevant, not to neurosis, but to extroversion-intro- 

ersion. What we have called excessive degree of socialization, 

ue to strong conditionability, these writers call Super-Ego; 

/hat we have called insufficient degree of socialization, due to 

;eak conditionability, these writers call Id. Mowrer appears 

be dealing exclusively with the extroverted symptoms and 

yndromes, Dollard & Miller with the introverted symptoms 

nd syndromes. If there is any truth in our theory, then it will 

te clear that both sides fail to come to grips with the problem 

if neurosis, or excessive emotionality, i.e., that which is in 

ommon to both hysterics and dysthymics, and deal rather 

yith a continuum which is orthogonal to neuroticism. Thus 

lur theory appears to reconcile the apparently contradictory 

observations of these men in a larger synthesis. It also succeeds 

n getting away from the reification inevitable in the use of 

uch concepts as Id and Super-Ego, and it provides a mecha- 

lism causally responsible for individual differences in these 

espects which has a solid experimental foundation and whose 

aws of functioning are reasonably well known. For all these 

easons we venture to offer this theory as not only an alterna- 

ive to, but as an improvement on, those of Mowrer, and 

Dollard & Miller" (pp. 221-222). Like Jourard, Eysenck is 

lere suggesting that there may be psychopathology on "both 

;ides" of what he calls the extroversion-introversion scale, taking 

ihe form of hysteria in the one case, anxiety (dysthymia) in the 

3ther. Normality and abnormality then depend upon another 

226 The Crisis in Psychiatry and RELIGIO^ 

But it will be useful to examine a few of the circum- 
stances which do, to be sure, often give a superficial 
impression of justification for the Freudian perception 
of the situation. Typically, when adult human beings 
present themselves for therapy, they are inhibited, de- 
pressed, anxious, conscience-stricken. But this, manifestly, 
is not their "normal" state of mind and being, to which 
they long to return. Quite regularly, when we get into 
the situation, we discover that a little while back these 
persons have been something very far from inhibited, 
repressed, unexpressive. A psychoanalytic friend of mine 
used to be fond of saying: ''There is just one thing wrong 
with the people who walk through the door of my office: 
they haven't been having any funJ' They were, to be 
sure, at the moment too depressed and too anxious to 
enjoy life. But when we go into the question of how 
they got that way, information is usually forthcoming 
which clearly suggests a very different interpretation ol 
the situation. 

But what of the person who is more or less chronically 
over-conscientious: the so-called obsessive-compulsive oi 
the victim of religious scrupulosity? These are certainly 
driven, tortured people; what is their underlying "dyna- 
mics"? We can, of course, assume that Lady Macbeth 
had a hand-washing compulsion because her mother (oi 
nurse) was too zealous in "cleanliness training" and thus 
gave to My Lady spuriously high standards in these mat- 
ters. Or we can assume, as Shakespeare obviously did, 
that the excessive preoccupation with "hand-washing" 

variable, termed "excessive emotionality," which is independeni 
of (orthogonal to) the first dimension. All of which, it seems, 
tends to beg the question: What determines the proneness tc 
this excessive emotionality? Dr. Eysenck has, I believe, toe 
quickly and for logically insufficient reasons dismissed the 
matter of id-ego-superego balance as irrelevant to the probleir 
of neuroticism. And informal reports from his laboratory indr 
cate that the empirical justification for his attempted re-^inter- 
pretation may not be as substantial as it appeared to be (in 
1957) when The Dynamics of Anxiety and Hysteria was pub- 
lished. But it is, of course, very much to the good that Dr. 
Eysenck and his co-workers have been willing to attack this 
problem in terms of evidence other than that provided by mere 
clinical observation and impression. 


Theory of Psychopathology 227 

/as energized by a displaced guilt which, in its own right, 
i'as only too terribly real. In the case of the Catholic 
mo must confess and confess, without deriving any 
elief therefrom, may we not also reasonably suspect 
with Stafford, 1950) that this compulsion continues 
irecisely because the individual is careful to see that 
lis "confession" never goes all the way, never really gets 
the heart of the matter? It is, of course, not at all 
lifEcult to find instances of displaced — and therefore 
eemingly unrealistic, unjustified — guilt. We must be 
areful not to accept a superficial perception of the 
situation as basic and ultimate. 

In light of considerations such as those just advanced, 
ome may ask: But is it not possible that the picture has 
hanged? Perhaps it is true that the majority of clinical 
)roblems today involve real moral inadequacy or fail- 
ire; but during the so-called Victorian era, in which 
"•reud made his original observations and formulated his 
heories, may not the picture have been typically other- 
vise? We cannot, of course, say categorically that such 
m interpretation is untrue, but it is improbable. Freud, 
ve must recall, lived and worked in Vienna, which was 
lever exactly famous for its prudery or restraint in sexual 
natters. Besides, as Progroff (1956) has, recently pointed 
)ut, Adler, Jung, and Rank (also Stekel and many 
Dthers) broke with Freud, not on personal grounds, but 
because they could not find in the clinical data justifica- 
:ion for the inferences which Freud boldly drew. The 
lata to which these men had access were essentially the 
jame as Freud's, yet they could not agree with him, even 
:hen (see also Ichheiser, 1960). 

There can, of course, be little question that sexual 
norality was somewhat stricter and probably better ob- 
;erved 60 or 70 years ago than it is today. But the 
question is: Was it excessively high then or is it danger- 
ously low now? Many astute observers of the contem- 
porary scene (LaPiere, 1959; Fitch, 1960) are suggesting 
that the latter assumption comes closer to the truth of 
the matter. 

It is, of course, clear that man is more susceptible to 
self-condemnation and therefore "neurosis" (if he han- 
dles his guilt badly) when he holds high standards for 
iiimself than when his standards are low or nonexistent. 

228 The Crisis in Psychiatry and Religioi« 

And as I have suggested on another occasion [Chaptei 
9], Freud's "mission," as he conceived it (see Fromm 
1959), v^'as to introduce a new era of "psychologica il 
hberty" (Bakan, 1958). We are now far enough intc 
this "era" to have both a retrospective and a prospectiv 
view of it, which we do not seem to like. In simples 
terms, it involves a level of morality and responsibility' 
comparable to that of beasts in a jungle, each of whicb 
"thinks" essentially of himself and his "natural" needs! 
and has a minimum of social awareness. j 

Recently an intelligent woman told me of a conver-i 
sation she once had with an analytically-oriented child- 
guidance expert. She said one of her teen-age sons' chores! 
around the house was that of emptying the waste baskets. 
Sometimes he was dilatory or refractory about doing this. 
Now, asked the mother, "Should we require him to 
perform this task or should we let him do as he likes 
about the matter?" The reply was, "But why should 
the boy have to do this if he doesn't want to. He didn't 
ask to be born into your family." This may be one way 
to avoid inner conflict in human beings, to let children 
grow up as mere "blobs" (Robert Fitch's term!); but 
socially and, in the long run, individually (see Link, 
1937), it is surely a form of "treatment" that is worse 
than the original "disease." 

In light of the developments which have been alluded 
to here, present-day apologists for psychoanalysis and 
kindred "therapies" are fond of saying: "Yes, to be sure, 
there were some inadequacies and errors in Freud's orig- 
inal formulations and prescriptions. But there have been 
great advances in our science since Freud's time." How- 
ever, on close inspection, these alleged "advances" turn 
out to be more nearly in the nature of retreats. One of 
the allegedly great new developments in psychoanalysis 
is the shift from the original emphasis upon unconscious 
mechanisms to so-called "ego psychology," which in- 
volves, essentially, a new emphasis upon what has always 
been known as ego strength, character, or "will power." 
One of the distinguishing features of Freud's doctrine 
was its emphasis on "The Unconscious," and now this 
is being abandoned in favor of "ego psychology," which 
analysts are frank to say they as yet know very little about 
"because it is so new to us and we are only beginning 

\ Theory of Psychopathology 229 

[0 investigate it." Common sense has been concerned 
A'ith these matters for a very long time! 

The most seminal and indigenous movement in Amer- 
can psychiatry during this century has unquestionably 
3een the emphasis of Harry Stack Sullivan (following 
t.eads suggested by Adolph Meyer) upon the interper- 
sonal nature of psychiatric problems, an emphasis which 
fias been echoed, in one form or another by virtually all 
of the so-called neo-Freudians, notably including Eric 
Fromm and Frieda Fromm-Reichmann. But is this new? 
Throughout history, the world over, it has been assumed 
that there is a connection between "sin" and ''sickness," 
i.e., between how one deals with others and what happens 
to oneself. The apostle Paul gave this principle its classi- 
cal Christian formulation when he proclaimed that the 
"wages of sin. is death," a psychological and spiritual 
death (as opposed to the abundant life which comes 
from the reverse of evil); but the principle itself is a 
universal one and by no means exclusively Christian .^ 

No, the modification and revisions which Freud's fol- 
lowers are having to make in their theories and practice 
ire not extensions in the direction which Freud origi- 
nally took, but are rather "advances to the rear." They are 

^ Since the above was written, Dr. Perry London and I have 
conducted a graduate seminar on "The Nature and Manage- 
ment of Guilt," in which many of the foregoing issues were 
considered. In response thereto, pro-Freudian students made 
the following points: (1) Psychoanalysis is still a "young 
science" and has perhaps not yet had a fair chance to demon- 
strate what it can do. If one will pursue the references cited 
in this paper, I believe he will come to question the grounds 
for such optimism (if one can call it that!). And (2), a 
related consideration: Granted that, during the half century 
or so that psychoanalysis has been with us, the world has not 
greatly improved, may this not be due to other factors — such 
as urbanization and loss of primary-group contacts, the auto- 
mobile and television, two world wars, etc.? In other words, 
why blame psychoanalysis (the "Freudian Ethic") for all our 
ills? Historical progression (or retrogression) is, of course, 
always complicated, intricate, multi-faceted; and there is surely 
no disposition on the part of anyone to hold psychoanalysis 
exclusively responsible for the pervasive "sickness" of our 
society. But, in the light of the varied evidence now available, 
let's at least be very cautious about the continued assumption 
that psychoanalysis is the cure. 

230 The Crisis in Psychiatry and Religion' 

reversals^ which are euphemistically — and misleadingly 
— called "progress." 


OR ''the lord IS SLOW TO WRATH*' 

On numerous occasions, a supposedly devastating criti- 
cism has been leveled against the hypothesis that there 
is a connection between moral failure and psychopathol- 
ogy. Phrased in various ways, its basic form is this: If all 
neurotic and functionally psychotic individuals have a 
history of unacknowledged and unredeemed real guilt, 
are all sinful, guilty persons neurotic or psychotic? Mani- 
festly the latter is not true, and the stratagem underlying 
this question involves an effort to discredit the whole 
emphasis on moral considerations in mental illness by 
means of a classical non sequitur. Elsewhere [Chapter 3] 
I have called attention in this connection to that class 
of persons who engage in thoroughly evil, antisocial 
behavior but who simply do not have the character — or, 
as one may say, the "common decency" — to go crazy. 
It takes a fairly adequate personality to be seriously 
""disturbed"; in fact, the very power of neurotic and 
psychotic affects attests to their strength of character. 

Also, some persons have the good sense to rectify 
personal mistakes shortly after they occur and thus do 
not allow themselves to fall into a chronic state of sin, 
disgrace, "neurosis." But over and beyond these consid- 
erations [cf. Chapter 10], there is another phenomenon 
about which I should like to speak in a little more detail. 

Imagine, if you will, a sort of "teeter-totter," such as 
shown in Fig. 1. A child, let us assume, is normally born 
on the left side. He does not at first have to proye" 
himself. He is loved, accepted, "respected" because he is 
our baby — and can, at first, do no wrong. But then, as 
the months and years pass, we begin to make demands 
upon him to "be good." Our approval is no longer auto- 
matic, unconditional. In a word, the child's socialization 
begins. Let us assume that all goes well in this connec- 
tion and that, despite occasional mischief or naughtiness 
(i.e., light forms of "sin"), this child remains basically 
good, i.e., learns how to earn approval, respect, trust. 
We say the child is developing well and deserves a good 

A Theory of Psychopathology 231 


Fig. 1. Diagram suggesting how a gradual impairment of 

\;self -respect {through continued wrong-doing) may lead to a 

sudden emotional ''imbalance" or ''breakdown." Only by again 

getting the virtue in one's life to outweigh the evil can the 

balance be righted" and "equilibrium" restored. 

deal of "credit" — which is represented by the "box" 
shown on the left end of the teeter-totter and which is 
experienced subjectively as self-respect. 

The years pass. This child becomes an adolescent and 
[is no longer under close parental supervision and guid- 
ance. Now he (or she) begins to try his wings a bit, to 
reality test." What would happen, our youth wonders, 
if he tasted the "forbidden fruit." And he makes, let us 
say, a brief excursion out on the wrong or "evil" end of 
the teeter-totter and then retreats again to the good end. 
Our young adventurer may have a little apprehension or 
guilt" afterwards; but if he is "discreet" and doesn't 
advertise" his foray, he may very well find, as did Adam 
and Eve, that nothing happens! He then begins to 
wonder even more: perhaps he has been swindled — ^by 
his parents, by society. Perhaps, as we were fond of 
saying in the 1920's, morality is "the bunk" and that 
by observing it one loses out on all manner of good things. 

The rest of the story follows a familiar script. Our 
hypothetical youth returns to the wrong end of life's 
teeter-totter again and again, and eventually decides to 
remain there "in his heart" but to deny this overtly. Now 
the "credit" begins to pile up on the other end. And 
eventually a day comes — perhaps relatively soon, perhaps 
only after many years — when something very "mys- 
terious" happens: the teeter-totter tips into the position 
shown by the dotted lines; and we say of our young (or 
now perhaps not-so-young) friend that he has had a 
nervous "breakdown," that he has lost his balance^ 
become unstable. 

What, now, can a person in such a predicament do to 

232 The Crisis in Psychiatry and Religion 

be "saved"? It would appear that two equally misleading 
answers have been given to this question in our time. 
Protestant theology has preached a doctrine of "justifica- 
tion by faith." Place your trust in God and believe on 
Jesus Christ, we have been urged, and your sins will be 
immediately forgiven. And for those who prefer a "scien- 
tific" rather than a "religious" approach, there has been 
the doctrine of "justification by insight." In the latter 
approach, one comes to see that his sins are not real and 
that he doesn't really need forgiveness. It is hard to 
determine which of these doctrines has been the more 
pernicious. Bonhoeffer, in his book The Cost of Disciple- 
ship (1958), has eloquently condemned the conventional 
Protestant approach to personal salvation and change as 
a doctrine of "cheap grace" — and hence no grace at all. 
And although psychoanalysis can hardly be accused of 
being "cheap" in the monetary sense, its great appeal has 
surely likewise arisen from the assumption that one could 
buy his way out of perdition, without being otherwise 
unduly inconvenienced or anguished. 

For those who are now disillusioned regarding both of 
these easy ways to "salvation," it is beginning to appear 
that "the way" is indeed hard and the gate narrow. 
Emotionally disturbed persons have not talked them- 
selves into their difficulties; they have acted, misbehaved; 
and many are now persuaded that one likewise cannot 
talk (or pray) himself out of them. It is surely unre- 
pented and unredeemed evil actions that destroy our 
self-respect and moral credit; and one can hardly escape 
the conclusion that these cannot be recaptured by any 
means other than compensating good actions and deeds 
[cf. Chapter 12]. 

A number of interesting and important implications 
flow from this way of viewing sin and psychopathology. 
To continue with the same physical analogy, it follows 
that just as one does not immediately become neurotic 
upon departing from virtue, so does one not immediately 
become "well" by "being good" for a little while. One 
has to work at it^ perhaps for a very considerable time. 
But just as conscience eventually condemns and turns 
against ("attacks") us for pursuing an evil life style, so 
will conscience eventually approve and reward us for a 
better type of conduct. To many modern-minded men 

i\ Theory of Psychopathology 233 

and women, traditional religious talk about the wonders 
of ''faith" is not very intelligible or convincing. But, in 
the present analogy, we nevertheless see the relevance of 
faith, at least of a somewhat different kind. Just as the 
fully destructive consequences of sin are not immediately 
experienced, neither are the redemptive consequences of 
i^irtue immediately forthcoming; and one has to have 
'aith, confidence that redemption will eventually come if 
3ne is only persevering. Many have tried to have faith 
in conventional religion or in psychoanalysis and been 
jorely disillusioned. But these are both purportedly easy 
"orms of redemption. Genuine deliverance is, by contrast, 
arduous but never, I believe, eludes those who stead- 
"astly pursue it. 

But what, one may ask, of those who "never had a 
chance"? In illustrating the operation of the teeter-totter 
principle, we deliberately selected an individual who had 
been born to and reared by parents who were themselves 
of good character, loving yet firm. But psychoanalysis 
explicitly teaches that neurotic difficulties arise from 
an excessively strong and unrealistically severe superego 
which is created by the hostility, rejection, and moral 
irrealism of parents. Hence, every neurotic is presumably 
a person who "never had a chance"; and would-be therapy 
all too often, therefore, takes the form of encouraging the 
patient to wallow in self-pity and resentment, thus nur- 
turing the paranoid tendencies which are already present 
in so many "sick" individuals. Is it any wonder that the 
accomplishments of such curative strategies are not im- 

Later in his life Freud was forced to admit that the 
supposed correlation between neurosis and harsh training 
in childhood could not be empirically confirmed. He 
said: "If the parents have really ruled with a rod of iron, 
we easily understand the child developing a severe super- 
ego, but, contrary to our expectations, experience shows 
that the superego may reflect the same relentless harsh- 
ness even when the up-bringing has been gentle and 
kind" (1933, p. 90). And when Freud then adds, can- 
didly, that he has not "fully understood" this paradox, 
we see how shaky is the whole theoretical and therapeutic 
edifice which he erected. The doctrine of what might be 
called "justification" by "circumstances over which one 

234 The Crisis in Psychiatry and Religion 

has no control" is thus pragmatically questionable and 
leaves both the cause and cure of personality disturbance 
completely up in the air [see Mowrer, 1961]. 

Also, I wish to call attention to a question which a 
student raised when I lectured a few months ago at a 
West Coast university. He said he wanted to know, quite 
simply, what could be done to "save" persons who are 
living on the wrong end of the teeter-totter but who 
have not yet broken down, fallen. I had to tell him that 
I, frankly, did not know. It is clear that "salvation" has 
two aspects. One may speak of saving a fallen, manifestly 
sick person in the sense of helping him to "rise again"; or 
one can work preventively, to try to "save" people in the 
sense of sparing them the anguish of an acute personality 
crisis. But most of the efforts which we psychologists 
have directed along supposedly hygienic or preventive 
lines have probably been as misguided as our more 
specifically therapeutic, or redemptive, efforts have been. 
The leaders of Alcoholics Anonymous insist that an alco- 
holic can't be "helped" until he "hits bottom"; and it 
may be that much the same view is justified with respect 
to other types of "confirmed sinners." But ideally there 
ought to be something that could be done of a preventive 
nature. This, of course, is the age-old problem of "evan- 
gelism" — the hope of conversion prior to crisis, of calling 
the "hard-of-heart" to repentance and reformation before 
it is "too late." Certainly it should make some difference 
what the prevailing ideology of a society is. So long as 
we continue to assume that there is no relationship 
between sin and psychopathology and that if, by some 
mischance, one happens to crack up, one can always hire 
an expert to put him back together again, wrong living 
will hardly hold the implications of danger (and this is 
an important part of what makes it "wrong") that it 
ought to have. But the repudiation of the notion of such 
a relationship has now proceeded so far that it is very 
difficult to see precisely what steps can be taken to alter 
either the specific modes of would-be therapy or the 
general tenor of what passes for "mental hygiene." 

In passing, it may be noted that there is today a re- 
vival of interest on the part of religious leaders in the 
concept of conversion, but with an attempt to avoid the 
emotionalism of the traditional "revival" meeting. 

Theory of Psychopathology 235 

iii. what happens when psychoanalysis 
IS "successful"? 

A variety of studies (Ausubel, 1960; Cartwright, 1959; 
Dollard, 1945; Eysenck, 1952; Masserman & Moreno, 
1959; Ubell, 1958) have indicated that no form of 
secular psychotherapy which has been around long enough 
and practiced by a sufficient number of persons to have 
a ''record" can boast of anything very substantial in the 
way of accomplishment [see also Chapter 1]. When 
the likelihood of spontaneous remission is taken into 
account, the accomplishment is, in fact, almost exactly 
nil. In other words, untreated controls (to the extent 
that such controls are possible) seem to fare about as 
well as treated groups. 

All this, of course, is well known in professional circles 
(e.g., see Fromm-Reichmann & Moreno, 1956) — and is 
gradually leaking through to the public. But I was quite 
unprepared to have an analyst tell me, a few years ago, 
the following concerning the findings of the psycho- 
analytic institute of which he was a member. Typically, 
he said, he and his colleagues have found that psycho- 
analysis has one of two outcomes: either the analysis is 
technically unsuccessful, which means that it fails to 
lessen the presumed over-severity of the superego, with 
the result that the patient continues to be neurotic; or 
the analysis is technically successful, i.e., the superego 
is softened-up and inner conflicts are resolved, but the 
patient then develops a "character disorder" and begins 
**acting out." 

Manifestly such a picture is not reassuring and con- 
firms more systematic reports of negative therapeutic out- 
comes and the growing popular disillusionment. But it 
was only recently that the theoretical implications of the 
report of my analyst friend dawned upon me. More than 
a decade ago, I began suggesting that analytic theory is 
wrong in at least one important respect: namely in its 
insistence that repression goes in the "direction" of the 
id, rather than (as I had come increasingly to suspect) 
toward the superego. And if this surmise is sound, it has 
important implications for the theory of character types. 

If, as Freud insisted, the neurotic is a person with an 

236 The Crisis in Psychiatry and Religion 

excessively severe, over-developed superego or conscience, 
the three major character types — criminal psychopath, 
normal, and psychoneurotic — could be aligned as shown 
in Fig. 2. Such an arrangement or conceptualization is 
neither unreasonable nor unattractive, in some v^^ays. It 
permits us, for example, to drav^ a standard, bell-shaped 
distribution curve over these three personality classifica- 
tions, v^ith the normal type of personality being ''aver- 
age," model, and therefore most frequent, and v^ith the 
two deviant forms of personality — psychopathy and psy- 
choneurosis — trailing off in opposite directions. In such a 
frame of reference, the therapeutic objective is, logically 
enough, to help the patient move away from his position 
of excessive superego severity, in the direction of psy- 

Psychopath^^^"^ ^, , ^"^^^Neurotic 

Fig. 2. Character typology inherent in Freudian psycho- 
analysis. Therapy [broken arrow) in this system consists, logi- 
cally enough, in trying to get the neurotic individual to "move'* 
in the direction of psychopathy but to stop in the region of 

chopathy, but to stop somewhere in between, in the 
general area of normality (see short broken arrow). This, 
of course, is in the direction opposite to that in which 
the efforts of the home, church, school, and other socializ- 
ing (character-building) institutions are largely directed 
(see long solid arrow). And so it was that psychoanalysis 
became a self-appointed and strident critic of socializa- 
tion (cf. Freud, 1930), on the grounds that it is pre- 
cisely those persons in whom this process has been most 
effective and proceeded furthest that neurosis is most 
likely to arise. 

If, on the other hand, the neurotic's basic difficulty is 
not that his superego is excessively severe but that the 
superego has itself been repudiated and ''repressed" [cf. 
Chapter 2], a very different character typology results. 

A Theory of Psychopathology 237 

as schematically portrayed in Fig. 3. Here the neurotic, 
rather than being seen as over-socialized, over-controlled, 
over-inhibited, falls somewhere in between the criminal 
psychopath or sociopath, on the one hand, and the 
normal type of person, on the other. Here it is assumed 
that such a person has an essentially normal, basically 
adequate superego but that it has been muted, dis- 
regarded, dissociated. This constellation or arrangement 
of character types might at first seem improbable, in that 
it can be encompassed ''statistically" only if one uses a 
i J-curve of the kind shown in the figure. To some this 
type of distribution may seen anomalous; but the work 


Fig. 3. A more realistic character typology. Here it becomes 
evident why a form of "therapy" which pushes the neurotic 
individual to the "left" if it succeeds, produces a psychopath 
rather than a normal person. 

of F. H. Allport (1934) and his students has demon- 
strated, more than 25 years ago, that the J-curve, far 
from being anomalous, is typical of social phenomena; 
and since character is manifestly a social product, we 
should not be in the least surprised to find that it is dis- 
tributed or varies, not according to the bell-shaped curve, 
but in conformity with the J-curve. 

Especially significant is the bearing all this has upon 
the report of psychoanalytic failures and ''successes" cited 
at the outset of this section. If the conceptual scheme 
shown in Fig. 3 is valid, then a form of "therapy" which 
attempts to push the individual toward psychopathy 
would be expected to *'work" in precisely the way re- 

238 The Crisis in Psychiatry and Religion 

ported: either the therapy would be unsuccessful and 
the individual would continue in his neurotic state oTy 
if the procedure did "move" the individual character- 
ologically, it would be over into psychopathy, not nor- 

A few weeks before writing this paper, I happened to 
sketch the foregoing considerations to a clinical psy- 
chologist who has long been in private practice in South- 
ern California — probably the most thoroughly analyzed 
area in the world; and his comment was that he could 
cite innumerable instances both of clear failure of psy- 
choanalysis and of its negative ''success," i.e., instances 
wherein it had been actively countertherapeutic — and 
very few cases in which it had had a genuinely beneficial 

As Bakan (1958) points out, psychoanalysis has, how- 
ever, had its greatest impact, not as an individual therapy 
(great as that has, of course, been ) , but as a broad social 
ideology and personal philosophy. The Stanford sociolo- 
gist, Professor Richard LaPiere, in his book The Freudian 
Ethic (1959), advances cogent and numerous reasons for 
thinking that, as a social ideology and philosophy, analysis 
has been even more mischievous than as an individual 
"therapeutic" procedure, if for no other reason than that 
it has in this form affected so many more persons. 


If one adopts the view that neurosis arises, not from 
personal irresponsibility and immaturity (see Fig. 3), 
but from excessively high moral standards which harsh 
and unreasonable parents (and other socializers) have 
drilled and dinned into the individual as a child (see 
Fig. 2), it follows, ineluctably, that the individual is not 
"to blame" for his so-called neurotic difficulties. It is 
rather his father, mother, siblings, teachers, minister — 
anyone but himself. And soon the analysand, under this 
pernicious tutelage, is luxuriating in self-pity and smol- 
dering resentment. If there are any paranoid trends al- 
ready present, how else could they be more effectively 
fanned and fed? The distinguishing feature of the para- 
noid is that, unlike the depressive, he typically projects 

A Theory of Psychopathology 239 

his own outraged conscience out upon others and then 
perceives them as "after" him, and against him. 

Thus, it seems reasonable to infer that psychoanalysis, 
in its classical form and strategy, would drive individuals 
toward both sociopathy (psychopathy) and paranoia. We 
have already seen that the first of these outcomes does 
in fact occur. In ''successful" individual analysis and in 
the movement of society as a whole which has been 
encouraged by the "Freudian Ethic," we see the trend 
toward the "psychological liberty" which we first thought 
was going to be our salvation but which we are now 
'beginning to view instead as a scourge. While in South- 
ern California I repeatedly heard stories from clinical 
psychologists, ministers, and social workers concerning 
the youth of the "best families" in their communities: 
'i.e., families with money, education, leisure, and exten- 
sive psychoanalytic therapy. And what was the picture? 
The youth of such families, with distressing frequency, 
present a picture of demoralization: little personal ambi- 
tion, self-centeredness and selfishness, dope addiction, 
general defiance and insubordination, illegitimate babies, 
and the rest. 

The situation came particularly close to me in the 
following incident. At the home of one of my friends, I 
was casually watching a little girl (perhaps four years old) 
and her mother in an adjoining yard. The child was 
throwing a ball for a kitten to chase and having some 
difficulty with her coordination. Presently she made a 
particularly awkward throw; and I heard her say, "Oh, 
God! God damn it!" as casually as a child of an earlier 
generation might have said, "Oh, my!" or possibly "Drat 
it!" Her parents have very likely had the benefit of our 
best schools and colleges; and if they have not personally 
"had therapy," they know well the direction in which 
one is supposed to "move" therein and how, according 
to therapeutic doctrine, to bring up children without 
neurotic scruples and inhibitions. The difficulty is that 
we thus also bring them up without character. 

Following a lecture in another state, a middle-aged 
woman tearfully spoke to me about her grown son: he is 
now, she says, himself trained as a social worker but has 
been "in analysis" for several years and still is; and as a 
part 0/ his therapy he has been encouraged to blame his 

240 The Crisis in Psychiatry and Religion 

mother for all his difficulties, has little or nothing to do 
with her, and seems to be increasingly paranoid and 
hostile in his general outlook. Recently a psychologist 
told me (I unfortunately have misplaced the reference) 
of a factor-analytic study in which paranoid and socio- 
pathic traits come out as a single factor. This is hardly 
surprising, since both types of individuals perceive their 
trouble as "out there/' as indeed it is for the sociopath; 
and although the paranoid individual has, more than the 
sociopath, internalized the norms of the culture, he 
rejects them so strenuously that he can experience them 
only in projected (delusional) form. How astonishing 
that we should have adopted as ''therapy" an ideology 
and interpersonal strategy which we are now beginning 
to see moves us away from the more benign forms of 
personality disturbance (depression, anxiety states, etc.), 
not toward normality, but toward the two most malignant 
forms of personality deviation known to man! ^ 

*Here I wish also to comment upon a question which is 
posed by the undedying logic of this paper. As we know, the 
prospect of recovery is always good in the depressions but, at 
least with present methods of treatment, poor in schizophrenia. 
Why should this be the case? Many contemporary students of 
the problem are inclined to agree that depressions are pre- 
dominantly "psychological," i.e., involve a "working through" 
of personal problems but assume, because of its greater chron- 
icity, that schizophrenia has a more constitutional, or endog- 
enous, basis. In his 1936 book. The Exploration of the Inner 
World, Anton Boisen advanced an intriguing hypothesis which 
has, I feel, received too little consideration: namely, that 
schizophrenia tends to be chronic and, not infrequently, "pro- 
gressive" because the individual manifesting this disorder "re- 
fuses" to admit his guilt and undergo appropriate remorse or 
make fitting restitution. Perhaps sociopathy and schizophrenia 
are, therefore, presently "untreatable" for much the same 
reason: in both conditions the individual does not take respon- 
sibility for his antisocial and immoral acts; but the symptom- 
ology is different because, as indicated above, the sociopath 
(as a type) has no conscience whereas the schizophrenic has 
one but projects it. The depressive, by contrast, "gets well" 
because he has a conscience and, through the depression, comes 
to terms with it. If this understanding of the situation is vahd, 
it might lead to important innovations in treatment: notably, 
an approach which would help the schizophrenic move, not 
toward sociopathy, but toward the depressive syndrome. 

A Theory of Psychopathology 241 

Elsewhere (p. 163) I have quoted Schiller to the effect 
that "Life may not be the highest possession, but guilt is 
the greatest evil." Nietzsche's ''Superman," we recall, was 
to live beyond good and evil, without guilt; and Adolf 
Hitler, World War II, and the mass extermination of 
Jews were some of the horrid manifestations of this dream. 
More subtle but nonetheless insidious and deadly, the 
Freudian Ethic implies the same philosophy in another 
guise. And it is no accident, surely, that it has prepared 
the way in this country for the widespread and growing 
interest in Zen Buddhism. One of the Chapters in Alan 
W. Watts' (1959) book. The Way of Zen, opens with 
this Zen Buddhist poem: 

The perfect Way is without difficulty. 

Save that it avoids picking and choosing. 

Only when you stop liking and disliking 

Will all be clearly understood. 

A split hair's difference. 

And heaven and earth are set apart! 

If you want to get the plain truth. 

Be not concerned with right and wrong. 

The conflict between right and wrong 

Is the sickness of the mind. 

On the front of this book is a Buddha, arms folded, 
eyes closed, and countenance inscrutable. How different 
are the outspread arms and open countenance of Christ! 
Why this abandonment of the Judeo-Christian faith for 
Nietzsche, Freud, and Zen? The answer, I believe, can 
only be found in certain features of the Protestant Ref- 
ormation, especially as they were shaped and expressed 
by John Calvin. His doctrine of predestination and human 
helplessness paved the way for the despair of Kierkegaard 
and the anger of Nietzsche. Roger L. Shinn in The Exis- 
tentialist Posture (1959) credits Nietzsche with saying 
that "The churches are the tombs of God" and Kierke- 
gaard with accusing "the churches of making a fool of 
God" (p. 70). It would appear that some revisions in 
the realm of theology are quite as urgently needed, if 
our civilization is to survive, as are called for in the area 
of secular "therapy." 

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Bultmann, R. K. {See Niebuhr, 1960) [184]. 

Burkhart, R. A. [221]. 

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244 Bibliography and Author Index 

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Gandhi, M. [145,146]. 

Gilkey, L. B. (1960). Calvin's Religious Thought. Mo- 
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Glover, E. {See Kubie, 1956) [121]. 

Goldb runner, J. (1955). Holiness is Wholesome. New 
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Gutheil, E. (1958). Pseudoneurotic Symptoms in Psy- 
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Bibliography and Author Index 247 

Haak,N. [140, 141]. 

Haitzmann, C. (See Freud, S., 1923 [118]. 

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Hegel, G.W.F. [143]. 

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Hoch, P. H. {See Fromm-Reichmann and Moreno, 
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Hocking, W.E. [66]. 

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248 Bibliography and Author Index! 

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Bibliography and Author Index 249 

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250 Bibliography and Author Index 

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Paul, The Apostle [14, 109, 170, 186, 187-189, 220, 

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Pfister, O. (SeeBakan, 1958b) [115]. 

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Pirandello, L. [179]. 

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r>l^^1r^n-i-i XTo-cTr Vf^rV • Tnlicin Pr/^cc f?! 74 7771 

Bibliography and Author Index 251 

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Rank, O. [21,24,227]. 

Richards, I. A. [149]. 

Riese, W. (See Shoben, 1957) [39]. 

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Russell, Anna [49, 53]. 

Schiller, J. C. F. [163-164,170]. 

Schleiremacher, F. E. D. (See Niebuhr, 1960) [184]. 

Schneiderman, L. (1954). Anxiety and Social Sensi- 
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Shakespeare, W. [88, 217, 226]. 

Shinn, R. L. (1959). The Existentialist Posture. New 
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Shoben, E. J., Jr. (1955). Anxiety vs. Immaturity in 
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Solomon, H. C. (1958). The American Psychiatric As- 
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Steiner, L. R. (1945). Where Do People Take Their 

252 Bibliography and Author IndejI 

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Szasz, T. S. (1960). The Myth of Mental Illness. Amer. 
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Temple, W. [182]. 

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Tournier, P. (1957). The Meaning of Persons. New 
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Bibliography and Author Index 253 

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Zilboorg, G. {See Fromm-Reichmann & Moreno, 1956) 


Subject Index 

Absolution, doubtful, 106 

and forgiveness, 195 
Abstractions, Asiatic, 182 
Acceptance, 1 3, 78 
Accountability, 40, 5 3 

one-sided, 159 

social, 43 
Acting out, 235 
Action, vs. insight, 46, 1 39 

prescription for, 137, 221 

redemptive, 232 

in sin and salvation, 78 
Action Research, 176 
Affiliation, social, 12 
Agitation, following confes- 
sion, 99, 104 
Alcoholics Anonymous, 46, 

109, 140, 150, 233 
Altruism, 13 
Ambition, 106 
Anti-Semitism, 117 
Anxiety, and confession, 99, 

and estrangement, 148 

as a fever, 99, 104 

friend or foe, 33 

and repression, 120 

theoryof, 68, 83, 148 
Apology, 202 
Asceticism, 9 

waning, 10 
Atonement, a bloody doc- 
trine, 188 

outmoded, 199 

rituals of, 102 

substitutionary, 147, 188, 
Authority, and competence, 
51, 219 

lack of, 218 

sacramental, 174 

Balance sheet, moral, 1 89 
Bankruptcy, moral, 152 

Behavior theory, 1 5 
Behaviorism, 4, 6, 15 

antiquated, 5 
Believers, priesthood of, 150 
Belongingness, 13 
Bible, consistency of, 188 
Blame, and neurosis, 49 
Breakdown, nervous, 153, 

Buchmanism, 109 

Calvinism, indefensible, 183 
paradoxes of, 159 
a perversity, 1 60 
and psychoanalysis, 1 60 
Catholicism, and absolution, 
a challenge to, 208 
and mental health, 107 
metaphysical claims of, 

paradoxes of, 204, 206 
and science, 111 
and works, 189 
Catholics, mental health of, 

194, 204 
Character, and community, 
214 ff. 
and guilt, 213 
and neurosis, 43 
strength of, 215, 230 
typology, 236 
Character disorder, 235 
Charity, 13 

commercialized, 166 
and personal change, 219 
secret, 198 
Chastisement, redemptive, 

Cheap grace, 190,232 
Chemotherapy, 13, 44, 51, 

Christianity, and Judaism, 


UBjECT Index 

a minority movement, 172 

uniqueness of, 182 

hurch, and state, 166 

hurches, a challenge to, 60, 

default of, 59 

and mental disease, 61, 162 

openness of, 71 

reformation of, 172 

lergymen, competence of, 

inconsistency of, 157, 186 

as professors, 174 

psychoanalyzed, 160 

linical movement, deflec- 
tion of, 64 

linical training, for clergy- 
men, 62 ff. 

limitations of, 73 

ommunication, 83 

ommunity, 180 

achievement of, 147, 191 

and character, 214 flf. 

of sinners, 191 

ompetence, interpersonal, 

ompulsion, 226 

onfession, 43, 91 ff., 180 

and absolution, 99 

and action, 78, 102 

and agitation, 99 

and atonement, 101 

Catholic, 109, 201 ff., 227 

and community, 147, 214 

of crime, 99 

defects of, 194 

as a deterrent, 195 

directly to God, 202, 216 

and honesty, 215 

to laymen, 107, 195 

vs. insight, 107 

insufficient, 94, 104, 202 

motivation for, 75 

objections to, 190, 193 

officially sanctioned, 190 

and openness, 109 

in Protestant Churches, 

or psychoanalysis, 192 

reconsidered, 192 

and recovery, 220 

relief from, 95 

and restitution, 55, 83 

return to, 137, 189 ff. 


as a sacrament, 201 

in the sects, 140 

therapeutic, 92, 193, 
201 ff. 

three steps in, 191 

value of, 175 

well received, 98 

why necessary, 202 

without recovery, 98 
Confidence, need for, 233 
Confinement, and expiation, 

Conflict, in Catholic posi- 
tion, 207 

constructive aspects, 25 

ethical, 146 

between Freud and Moses, 

moral, 214 

in psychopathology, 1 54 

in religion, 66 

and repression, 20 

resolutions of, 144 

of science and religion, 183 

in the seminaries, 63 

in therapeutic relationship, 
Conformity, paradox of, 130, 

Conscience, approval by, 33, 

clear, 188 

combatting, 114 

compared with court, 100 

diseases of, 22, 37, 68 

distrust of, 37 

externalization of, 32, 240 

and eyes, 94 

fairness of, 196 

morbid, 64 

and neurosis, 31 

outbreak of, 153 

outraged, 126, 239 

and paranoia, 239 

as prattler, 67 

projected, 32, 240 

protests of, 25 

and recovery, 64, 240 

rejection of, 84, 240 

repression of, 29, 68, 127, 

and rigidity, 5 5 

and the unconscious, 17 

value of, 162 


variations in, 27 
vengeance of, 23 
as voice of God, 32 
Conscientiousness, false, 223 
Constitution (see C)rganic- 

Consumption, conspicuous, 

Conversion, 57, 234 
Counseling, as confession, 78, 
and psychotherapy, 33, 
107 ff. 
Courage, 31 

Creativity, vs. conformity, 
myth of, 143 
Credit, moral, 231 
Crime, and punishment, 100 

and retribution, 1 68 
Criminals, rehabilitation of, 

Crisis, institutional, 1 38 

moral, 151 
Culture, disunity of, 143 

Demoralization, social and 

personal, 239 
Depersonalization, 216 
Depression, and guilt, 91, 97 

vs. paranoia, 240 

self -limiting, 100 
Despair, Christian, 160 

and the devil, 117 
Determinism, 58 

psychic, 159 
Deviance, open, 153 
Devil, as cure for depression, 

Freud identified with, 114- 

and the id, 122 

powers of, 118 

as principle of evil, 119 

as a projection, 125 

and psychopathology, 80, 

as suspended superego, 

as tempter, 117 
Diagnosis, differential, 224 
Dick Tracy Theory, 86 ff. 

objections to, 88 

Subject Index 

Discipline, and normality, 42 

penitential, 192 
Disgrace, and disease, 82 
Disillusionment, 235 
Disobedience, with integrity, 

Dissociation, 165 
Drug Therapy {see Chemo- 

therapy ) 
Duplicity, destructive, 146 

Economy, expanding, 146 

Education, public, 166 

Ego psychology, 31 E, 34, 

45, 228 
Ego strength, 34, 36 
Electrotherapy, 111 
Embezzlement, 152 
Emotionality, excessive, 226 
Encounter, 179 
Equilibrium, moral, 231 (see 

also Balance sheet) 
Estrangement, 131 
Ethics, and psychopathology, 
and society, 146 
Evangelism, 234 
Evidence, canons of, 171 
Evil, and bondage, 31 
corporate, 122, 146 
personal and secret, 147 
problem of, 142 ff. 
Evolution, evidence for, 14 
and psychoanalysis, 1 5 
and psychology, 4 ff. 
theory of, 1 
Existence, meaning of, 52 

moral basis of, 5 3 
Existential Analysis, 1 80 
Existentialism, 52, 177 ff., 

184, 185, 241 
Ex-patients, as therapists, 218 
Experience, denial of, 164 
Expiation, 97 ff. 
Extroversion, 225 
Eyes, as conscience symbol, 

Faith, reinterpreted, 233 

and works, 221 

without works, 187 
Father, corruption of, 96 
Fear, and authority, 213 

in schizophrenia, 86 

of sex, 213 

iuBjECT Index 

^ees, and self-punishment, 

i'ellowship, 13 
"orgiveness, 25 

not accepted, 197 

too easy, 188 

over-worked, 188 

and prayer, 214 

presumption of, 196 

and psychoanalysis, 175 

questionable, 195, 196 
; traffic in, 106, 110, 138 
.^'raudulence, personal, 150 
^'ree association, 101 
"reedom, and alienation, 52 

loss of, 31 
F'reud, and depression, 117 

as the devil, 116, 132 

his mission, 131 

as Moses killer, 115 
^'reudian Ethic, 241 
E^'reudianism, 131, 165 
F'unctionahsm, 4, 6, 8, 1 5 
F'undamentalism, 61, 165 

l^lory, lost, 173 

I^od, conceptions of, 37, 114 

and conscience, 29, 37, 59, 

faith in, 37 

flight from, 155 

grace of, 159 

hand of, 30 

inscrutability of, 160 

of justice, 59 

as love, 59 

love of, 219 

manifestations of, 79-80, 

as person, 182 

and psychopathology, 79 

short-cut to, 106, 216 

and sin, 185-187 

and the unconscious, 128 

unpredictable favor of, 159 

wrath of, 28 ff., 79-80, 188, 
Good Works, condemned, 

among Mormons, 209 

objections to, 198 

and redemption, 232 
Grace, costly, 108 

debased, 149 


and disgrace, 1 89 
the gift of God, 186 
inadequate, 100, 108, 189 
over-emphasis on, 106 

(see also Cheap Grace) 
Group dynamics, 177 
Group practice, by clergymen, 

_ 218 
Guilt, analysis of, 32 
attitudes toward, 57 
barrier to marriage, 210 
a central problem, 167 
and confession, 91 ff. 
conscious or unconscious, 

constructive, 25, 64 
definition of, 81, 130, 

142 ff. 
displaced, 82, 227 
and divine grace, 175, 181 
as an evil, 164 
excessive, 75 
false, 175,200,213 
feeling or fact, 105 
vs. guilt feelings, 56, 104 
harmful, 66 

historically considered, 105 
imaginary, 81 
and incest, 209 
legal, 167 
masks of, 59 
mismanagement of, 59 
as motivation, 199 
and neurosis, 126, 213 
in psychoanalytic theory, 

and psychopathology, 217 
reaction to, 54 
real or false, 56, 68, 81, 

89, 142, 190 
reality of, 83, 213, 217, 

beyond religion, 190 
and self-loathing, 223 
and social reality, 223 
and the state, 167 
and superman, 241 
not taken seriously, 128 
taken seriously, 108, 109 
unatoned, 131 
unresolved, 200 

Hallucination, and con- 
science, 94 


Subject Indei 

Healing, through confession, 

or confession, 107 


and neurosis, 41, 78 

Hell, eliminated, 59 

vs. repentance, 100 

and neurosis, 48 

not sufficient, 197 

in religious thought, 61 

Insurance, and charity, 166 ] 

as state of mind, 42 

Integration, 215 

Helplessness, of man, 241 

into society, 215 

in sin, 241 

Integrity, 217 

Holy Spirit, basis of all re- 

and ego strength, 146 

ligion, 124 

and personal identity. 

and emotional disturbance, 

177 ff. 


value of, 216 

and a new synthesis, 131 

Introversion, 225 

and reformation, 173 

Inventiveness, social, 176 

significance of, 123 ff. 

Investment, personal, 1 39 

and the unconscious. 

Irresponsibility, 238 

125 ff. 

religious and psychoanaly] 

Honesty, contempt for, 146 

tic, 160 

and mental health, 145, 

Isolation, personal, 25 


social, 92 

Hospitalization, 157 

and temptation, 147 

after confession, 99 

Issues, vs. troubles, 135, 


by religious groups, 218 

Hospitals, church directed, 79 

Jealousy, 36 

failure of, 76 

Jesus Christ, as person. 


inadequate, 167 

revelation in, 182 

as mission field, 79 

Judaism, 112 

under-churched, 79 

Judgment, moral, 40 

Hostility, fear of, 83 

and suffering, 56 ff. 

Hypnotism, 111 

Justification, by faith. 


Hypocrisy, 152,202 

by insight, 232 

Id, and the devil, 122 

in Protestant doctrine, 


Identity, denial of, 217 

and integrity, 177 ff. 

loss of, 52 

and neuroticism, 216 

quest for, 135 
Ideology, 234 
Illness, defended, 203 ff. 
Immaturity, 238 
Impulse, repression of, 36, 

Incest, 209 

and insanity, 147 

and psychopathology, 96 
Indulgence, 105 
Inhibition, and character, 

Injustice, 161 

and psychopathology, 161 
Insanity, and character, 230 

and isolation, 148 
Insight, vs. action, 1 39 

Kabbala, 112ff. 
Knowledge, tree of, 121 

Latter-Day Saints, 208 

salvation in, 212 
Laws, universal, 183 
Learning theory, 31 
Liberation, emotional, 67 
Life, abundant, 10 
Life style, changes in, 153 
Lost sheep, 169, 171, 173 
Love, and charity, 57 

of God, 154 

and relatedness, 148 

Man, and community, 155 
cultivated, 179 
disillusioned, 175 
fall of, 120 
helplessness of, 159, 165 

|UBjECT Index 

nature of, 35, 54, 153, 178, 

predicament of, 175 

science of, 180 

self-domesticated, 38 

a social creature, 131 
/lartyrdom, 106 
Masochism, 141, 199 
/laterialism, 8 
/laturity, and religion, 71 
/ledicine, aggrandisement of, 

and morality, 58 

and psychology, 50 

and suffering, 58 
v/[editation, 113 
viemory, and illusion, 178 
viental Hygiene, and mo- 
rality, 9 ff. 
viental illness, a questionable 

concept, 51 
Viesmerism, 70 
Vlind, and adaptation, 1 

survival of, 16 

theories of, 5 
Vlind-body problem, 2 ff. 
Vlissions, foreign or do- 
mestic, 78 
Vlistakes, correction of, 151 
Mobihty, downward, 153 
Morality, 227 

apathy toward, 58 

and psychopathology, 23, 
58, 197 

and skepticism, 41 
VIoses, attacked by Freud, 

the lawgiver, 115 

ursurped by Freud, 115 
Mystery, religious, 187 
Mysticism, 185 

and chaos, 182 

and psychoanalysis, 113 

f^aturalism, and the Bible, 30 
Natural law, 125 
Needs, psychological, 16 
Negativism, moral, 181 
Nemesis, 200 
Neo-Freudianism, 161 ff. 
Neo -orthodoxy, 184 
Neurosis, cause of, 226 
and character, 43 


and childhood training, 

and estrangement, 25, 169 
as illness, 50 
two kinds, 223 
and morality, 8, 24, 44, 

nature of, 26 ff., 54 
presenting symptoms of, 

and responsibility, 48 
and retribution, 200 
so-called rigidity in, 31 
and sin, 48 
and socialization, 34 
theory of, 1 5 
Neurotics, held blameless, 

no interest in, 110 
life history of, 84 
Nihilism, intellectual, 181 

moral, 241 
Nonconformity, constructive, 

Normality, 236 
conditions of, 34 
and rectitude, 151 
and values, 34 

Objectivism, 5 

Openness, and integrity, 145 
Organicism, 44, 240 
Oxford Group, 35, 109 

Paranoia, 151 

vs. depression, 240 
encouragement of, 233, 

immutabihty of, 101 
and resentment, 101 
and sociopathy, 240 

Parapathy, 23 

Parents, and conscience, 59 
influence of, 233, 238 

Penance, 195, 197 

Performance, level of, 224 

Persecution, ideas of, 98 

Personality, types of, 236 

Persons, or principles, 180 ff. 

Personology, 177 

Perversion, and depression, 

Phenomenology. 179 

Philanthropy, 219 


Philosophy, and counseHng, 

Phrenology, 70 
Positivism, 5 

Possession, and neurosis, 116 
Prayer, or action, 221 

use of, 220 
Preaching, and guilt, 75 
Predestination, 109, 187, 241 
Pretense, and guilt, 147 
Pride, sin of, 187, 198, 220 
Principle, return to, 185 
Principles, universal, 182 
Private practice, 77 
Promiscuity, and guilt, 98 
Protection, legal, 218 
Protestant Reformation, 39, 

ambiguities of, 176 

incomplete, 110 

and psychotherapy, 105, 

rejection of confession, 106 
Protestantism, and ambition, 

and guilt, 77, 106, 157, 

highly intellectual, 174 

paradoxes of, 107, 164 

and psychoanalysis, 160, 
175, 190 

and science, 112 

twilight of, 174 
Psychiatry, ambiguities of, 

changes in, 90 

competence of, 161 

interpersonal emphasis, 229 

the new faith, 67 

of Old Testament, 29 

and religion, 28 
Psychoanalysis, 1 

advances in, 45, 161, 228 

alternative views, 20 ff. 

blandishments of, 83 

a big business, 149 

and Christianity, 127 

vs. confession, 203 

not confirmed, 54 

cost of, 140 

criticisms from, 236 

defectors from, 227 

demise of, 22 

demoralizing, 239 

Subject Inde 

and the devil, 114 
disillusionment regarding, 

disintegration of, 123, 22 
paralyzing effect of, 133 
as a new ethic, 133, 23 
fallacies of, 54 
history of, 1 10 ff . 
and humility, 69 
impact on clergymen, 73 
impact in religion, 60, 

65 ff., 134 
inception of, 82 
inconsistent, 233 
and Kabbalism, 113 ff. 
and medical science, 49 
nontherapeutic, 161, 162 
permissiveness of, 228 
not for poor, 149 
premature acceptance of, 

presumptions of, 17 
a pseudo-science, 176 
re-appraisal of, 60, 68 
and religion, 111, 159 ff. 
vs. religion, 69, 112 
vs. religious therapy, 24 ff 
resistance to, 165 
results of, 121, 133, 159 

as science, 70 
self-centered, 220 
and sociopathy, 2 37 
spoofing of, 5 3 
therapeutic strategy of, 82 
as surgery, 38 
as therapy, 63, 175 
as way of life, 114 
weaknesses of, 1 32, 222 ff. 
Psychoanalyst, omniscience 

of, 17, 121 
as tempter, 118 
worry-free, 141 
Psychologists, and psycho- 
analysis, 50 
Psychology, academic, 1 
attraction of, 149 
and biology, 4 ff. 
crisis in, 2 
and evolution, 1 5 
and moral competence, 9 
and theology, 52 
Psychopathology, attitudes 

toward, 66 

Subject Index 

and conduct, 84 

and duplicity, 146 

history of, 28, 103 ff. 

and ideology, 51 

among monastics, 203 

moral basis of, 61, 91, 
103, 190 

nature of, 18, 81 ff. 

needed research, 84 

prevalence of, 7, 157, 208 

redemptive, 219 

re-interpreted, 83 

religious rejection of, 205 

without repression, 29 

and sin, 234 

social basis of, 17, 90 

and social values, 1 6 

susceptibility to, 163 

theory of, 151 

value of, 58 
Psychopathy, 38, 235 

(see also Sociopathy) 
Psychosis, as disease, 203 

hazards of, 78 

a state of sin, 148 
Psychotherapy, accomplish- 
ments of, 235 

as a business, 77 

chent-centered, 164 

and cultural change, 115 

in disarray, 3 

goals of, 237 

as guide to morality, 67 

limitations of, 140, 213 

nontherapeutic, 17, 101, 

reform of, 72 

re-orientation of, 105, 240 

and seduction, 93 

talk or action, 101 

and values, 103 ff. 
Punishment, need for, 199 

role in therapy, 56-57 

of sinners, 5 3 

value of, 39 

Real guilt, not recognized, 

Reality testing, 231 
Reconcilliation, of science 

and religion, 184-185 
Recovery, and personal 

change, 55 
from psychopathology, 240 


or reformation, 153 

and self -blame, 101 
Redemption, 148 ff. 

not easy, 149 

not for sale, 149 

and recovery, 55 

and reform, 141 
Referral, 45 

to other clergymen, 218 

dubious, 224 

to psychiatrists, 169 

rationale of, 74 
Reformation, 9 

contemporary, 15, 105 

incomplete, 171 ff. 

must continue, 172, 176 

a permanent movement, 

value of, 166 
Rejection, ambiguity of, 9 3 

of seductiveness, 95 
Relatedness, rupture of, 90 
Relationship, 180 

interpersonal, 12 ff. 
Release therapy, 125 
Religion, abdication of, 167 

and action, 182 

authenticity of, 62, 169 

clinical interest of, 61 

two dimensions of, 110 

in disrepute, 122, 168 

great potential of, 76 

impotence of, 112, 157 

inadequacy of, 168, 197 

and medicine, 62 

and mental health, 11, 32, 

and mental hygiene, 3 

predicament of, 60, 69 

priestly or prophetic, 140 

prostration of, 1 36 

and psychoanalysis, 52, 
111, 159 

as psychology, 1 

as psychopathology, 10, 63 

return to, 135 

revitalization of, 80, 136, 

and science, 14, 66 ff., 82 

scorned by Freud, 159 

shame of, 111 

subordination of, 76 

and theology, 220 

therapeutic, 212 


and the unconscious, 28 

vitality of, 1 1 

weakness of, 110 
Religiosity, increasing, 123 
Remission, spontaneous, 235 
Remorse, repression of, 68 
Repentance, 100 

call to, 30 

and change, 234 
Repression, 18 ff. 

direction of, 26 ff., 35, 126, 

dynamics of, 19 

vs. ego controls, 36 

elusive, 84 

failure of, 8 3 

Freudian, 26, 36 

and guilt, 26 

theory of, 127 

and the unconscious, 19 ff. 
Research, limitations of, 176 

need for, 81 
Resentment, 238 
Resiliency, 151 
Resistance, nonviolent, 145 
Resolution, and redemption, 

Responsibility, abandonment 
of, 240 

and forgiveness, 196 

moral, 43, 56 

and neurosis, 31, 48 

rejection of, 58 
Restraint, and recovery, 38 
Restitution, 152, 240 

or retribution, 168 
Resymbolization, 173 
Retribution, 167, 200 

vs. restitution, 102 
Revelation, divine, 125 
Revolution, cultural and 
moral, 131 

psychiatric, 132 
Righteousness, self-pro- 
claimed, 109 
Rigidity, neurotic, 55 

Sacrifice, misinterpreted, 189 

and recovery, 219 
Salvation, by grace, 186 

by psychoanalysis, 182 

not for sale, 140 

a social operation, 221 

Subject Index 

spurious, 232 

theories of, 109 

two kinds, 2 34 

uncertainty of, 1 60 
Salvation Army, 135, 140, 

Sanity, and humanity, 38 
Satan, 119 

Schizophrenia, and criminal- 
ity, 89 

Dick Tracy Theory of, 86 

diverse opinions of, 87 

and fear, 86 

as interpersonal disorder, 

and isolation, 92 

loss of self-esteem in, 87 

malignancy of, 101 

and possession, 116 

and pretense, 87 

as progressive terror, 104 

and secrecy, 87 

and sexual deviation, 90 

a social disease, 89 

theory of, 84, 85 ff. 
Schizophrenics, basically de- 
cent, 89 

indifference of, 87 

pseudoneurotic, 90 
Science, and religion, 125, 

176, 184-185 
Scientism, 58 
Scrupulosity, 65, 206, 226 
Secrecy, and ego weakness, 

and shame, 148 
Secularization, of various 

functions, 166 ff. 
Seductiveness, of client, 93 

as defense, 95 
Self, as social phenomenon, 

Self-acceptance, 162 

and sociopathy, 163 
Self-condemnation, 219 

capacity for, 161, 227 

in psychopathology, 161 
Self -contempt, 163 
Self-disclosure, 83, 108 
Self-examination, 178 
Self-interest, 217 
Self-knowledge, 178 

through confession, 192 

vs. self-revelation, 180 

Subject Index 

Self-pity, 238 

in psychotherapy, 1 64 
Self-punishment, construc- 
tive, 66 

in depression, 100 

disapproval of, 163 

unjustified, 161 
Self-rejection, 211 
Self-respect, recovery of, 202 
Self-revelation, cpst of, 190 
Self -revulsion, 151 
Seminaries, uneasiness in, 73 
Service, as sacrifice, 199 
Sex, and neurosis, 23 

and social adjustment, 
214 ff. 
Sexuality, acceptance of, 75 

fearof, 83, 213 

repressed, 119 
Shame, and salvation, 55 
Sickness, concept of, 39 

over-extension of, 168 

and pessimism, 40 

or salvation, 153 

vs. sin, 75 

a stultifying concept, 138, 
Significant others, 108 
Sin, acceptance of, 54 

act or attitude, 186, 188 

and atonement, 188 

definition of, 42 

and delusion, 98 

and depersonalization, 185 

destroys community, 191 

and expiation, 199 

forgiveness of, 232 

helplessness in, 165 

and mental sickness, 205 

objections to, 41 

original, 147 

and psychopath ology, 148, 

due to psychopathology, 
205, 211 

and punishment, 53 

and redemption, 51 

re-evaluated, 40 

repression of, 160 

and secrecy, 148, 216 

and self-hatred, 54 

vs. sickness, 43, 50, 67, 82 

or sickness, 87, 91, 229 

and sins, 185 ff. 


and sociopathy, 43 

and suffering, 43, 48 

as therapy, 205 

unpardonable, 66, 98 

and worldly hell, 42 
Sincerity, violation of, 86 
Sinners, confirmed, 234 
Social act, 140 
Sociality, 2, 220 

betrayal of, 131, 155 

loss of, 86 ff., 90 

man's inveterate, 153 

restored, 202 
Socialization, 225, 230, 233 

and neurosis, 48 

opposition to, 236 
Society, basic premises of, 147 

debt to, 100 

nature of, 38 

presupposes conscience, 

and religion, 173 
Sociology, and self-theory, 13 
Sociopathy, 27 

and paranoia, 239 

(see also Psychopathy) 
Souls, the cure of, 192 
Spiritual directors, 194 
Strength, personal, 198 ff. 
Suffering, misinterpreted, 58 

in psychopathology, 56 ff. 

redemptive, 58 
Suicide, 151 

and Catholicism, 107, 194 
Superego, harshness of, 54, 
66, 114 

as introjected parents, 161 

irrational, 32 

and Mosaic law, 115 

a negative agency, 127 

power of, 223 

repression of, 236 

severity of, 233, 235 

tyrannical, 158, 225 
Survival, psychological, 6 ff., 

question of, 1 39 
Symptoms, and anxiety, 26 
Synthesis, of psychology and 
religion, 103 

Talion, 200 
Taoism, 181 
Testimony, 14 


Theologians, compromised, 

on sin, 170 
Theology, and ethical con- 
cern, 184 

language of, 143 

misleading, 222, 232 

pastoral, 74 

perilous and arrogant, 175 

primacy of, 220 

and psychology, 176, 222 

recovery of, 171 

undisciplined, 171 

vagaries of, 170, 173 

vogues in, 170-171 
Therapist, as father, 96 
Therapists, secular, 224 
Therapy, and action, 46 

aim of, 30, 224 

nature of, 35, 38 

as personal growth, 34 

to undo repression, 20 

as transference, 25 
Total depravity, 189 
Transference, 113 
Treatment, ambiguities of, 

humane, 56 

as instruction, 44 

medical, 50 

as redemption, 45 

symptomatic, 153 

and temptation, 120 
Troubles, vs. issues, 135, 138 


Typology, character, 2 
Freudian, 236 

Unconscious, benevole 
conception of, 17 ff. 
content of, 27 
diabolical, 128 
Freud's theory of, 1 
and Holy Spirit, 12 
neurological basis ol 
re-examined, 28 ff., ; 
and repression, 19 ffJ 
vs. the unuttered, 1^ 
Uncovering, vs. coverii 
Understanding, 41 
Unreahty, sense of, 21 

Values, contempt for, 

moral, 143 

nev^^ interest in, 52 
Verification, of religioi 

claims, 207 
Virtue, and freedom. 

Will power, source ol 

Wisdom, secret, 113 
Working through, in t 

sion, 240 
Wrath, of God, 154, 2 

You, the real you, 178 

Zen Buddhism, 181, 2" 

4 22 16 


Date Due 





APR Q ] i 

i NOV 2 2 1988 

- 'v •J' 

The crisis in psychiatry and r main 

3 ISbS 032Tt bDSa 


R'^i«." >o;:"^m^ 

\ ^^ r 

.*«»•». II. .»«»'''